Hysteroscopy Procedure to Treat Causes of Abnormal Bleeding


What is abnormal bleeding? Why do women experience it?

Abnormal uterine bleeding is a condition where a woman suffers from heavy bleeding during the time of their menstrual cycle. In this situation, the bleeding is so heavy that a woman tends to change their sanitary pads every hour and more than one tampon a day.

Causes of abnormal uterine bleeding?

  • Abnormal uterine bleeding can be caused due to various reasons and some of them are mentioned below.

  • Pregnancy is the most common cause of abnormal uterine bleeding. Teenagers who become pregnant early in the mid 20 also experience abnormal uterine bleeding during the first few weeks of their normal pregnancy.

  • Use of Birth control pills and intrauterine device (IUD) can also lead to abnormal bleeding in women.

  • Polyps or fibroids that are benign tumors occurring in the uterus can cause heavy or irregular bleeding associated with unbearable pain.

  • Due to heavy menstrual bleeding in teenagers where the ovaries are unable to release the egg.

  • Due to infection of the cervix or sometimes thyroid related problems and even uterine or endometrial cancer can cause abnormal uterine bleeding.

  • Hormonal imbalance is also a major cause of abnormal uterine bleeding which is often termed as dysfunctional uterine bleeding.

  • Women who are in their 40’s – 50’s and are about to attain menopause can also experience heavy bleeding due to thickening of the uterus lining. This can also be a sign of uterine cancer.

Diagnosis of abnormal uterine bleeding by hysteroscopy

There are various diagnostic tests a doctor can recommend to evaluate the cause of abnormal uterine bleeding, some of which may include a pregnancy test, ultrasound test, endometrial biopsy, and hysteroscopy.

What is hysteroscopy?

Hysteroscopy involves usage of a hysteroscope which is a thin tube fixed with a tiny camera at its tip. This thin tube is inserted into the vagina to look inside the cervix and the uterus to determine the causes of abnormal bleeding. Hysteroscopy is of two types and it can be diagnostic or operative.

What are the two types of hysteroscopy?

There are two types of hysteroscopy

  1. Diagnostic hysteroscopy

  2. Operative hysteroscopy

Diagnostic hysteroscopy: It is usually used for diagnostic purposes along with other procedures like hysterosalpingography (HSG), laparoscopy and dilation and curettage. It helps in confirming the results of other tests. The procedure involves inserting an endoscope into the abdomen by making an incision below your navel. The endoscope is fitted with a tiny camera that helps view the outside of your uterus, ovaries and fallopian tubes. It can be used to diagnose the cause of repeated miscarriage, Locate an intrauterine device (IUD) and much more.

Operative hysteroscopy: this procedure is performed to correct the problem that has been diagnosed during diagnostic hysteroscopy. If an abnormal condition was detected an operative hysteroscopy can be performed at the same time, using small instruments that are inserted through the hysteroscope avoiding the need for a second surgery.

Operative hysteroscopy can be used to correct some of the following uterine conditions that involve

  1. Non-cancerous tissue growth like polyps and fibroids can be removed through a postoperative hysterectomy

  2. Operative hysteroscopy can also be used to treat abnormal bleeding conditions in which hysteroscope along with other instruments are used to destroy the lining of the uterus to treat and relieve the patient from heavy bleeding conditions.

  3. Asherman’s Syndrome: also referred to as tissue adhesions present in the uterine wall are characterized by bands of scar tissue that can cause changes in the menstrual flow and lead to infertility. Operative Hysteroscopy can help identify and remove such adhesions.

  4. Uterine Septum’s:  These are congenital malformations of the uterus in which the uterus cavity is divided by a septum. These septa are present from the birth and with the help of operative hysteroscopy, it can be removed.

How is hysteroscopy procedure performed?

Hysteroscopy procedure involves the following steps.

  1. A patient is allowed to relax prior to the procedure, where your doctor may give you sedatives and ask you to relax. After which you will be given general or local anesthesia to block the pain.

  2. Hysteroscopy procedure will be performed by your specialist where the doctor will first widen your cervix to insert the hysteroscope.

  3. Before inserting a hysteroscope you will be given certain medications inserted into the cervix to dilate the cervix.

  4. A speculum is inserted into the vagina and then the hysteroscope is slowly inserted through your vagina and gently moved into the cervix to the uterus.

  5. In order to expand your uterus carbon dioxide gas or a liquid solution is passed through the hysteroscope. This also promotes a clear vision of the uterus lining by washing away the extra mucus and blood.

  6. A light ray is passed through the hysteroscope that allows your doctor to see the uterus and the openings of the fallopian tubes present in the uterine cavity.

  7. The diagnostic hysteroscopy help identifies any abnormal condition and if surgery needs to be performed, it is corrected by inserting small instruments into the uterus through the hysteroscope.

The time taken for the procedure to be completed is usually very short and can be completed in less than five minutes. However, some complex conditions can require more time.

After the procedure one can expect mild cramping, spotting, for a few days. Medications can be provided to help ease the pain.

What are the benefits of hysteroscopy?

Hysteroscopy procedure is comparatively a better technique when compared to other methods like hysterectomy where the uterus is completely removed. Hysteroscopy provides a patient with the benefits of shorter hospital stay, faster recovery, few medications and saves a person from undergoing open abdominal surgery.

Risks associated with hysteroscopy procedure?

Hysteroscopy is a safe and effective procedure with a small percentage of risks associated with it. Some of the risks include.

  • Infection due to the opening of the cervix

  • Heavy bleeding due to puncture of the uterus or cervix while inserting a hysteroscope

  • Scarring of Intrauterine tissue

  • One should immediately consult their health care professional if experience fever, chills, or heavy bleeding.

  • In very rare cases, hysteroscopy can cause life-threatening problems in very rare conditions.

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