What is Hysteroscopy?

Hysteroscopy is the evaluation of the uterus with a special optical device by entering through the cervix. Intrauterine and uterine wall diseases can be safely diagnosed and treated through hysteroscopy. We talk about diagnostic hysteroscopy (imaging for diagnostic purposes); and operative hysteroscopy for treatment purposes. There is very little risk of misdiagnosis or erroneous treatment with hysteroscopy. Diagnostic hysteroscopy can be performed alone or in combination with laparoscopy.

When is Hysteroscopy Performed?

· Removal of polyps and fibroids.
· Adhesions: The adhesion of the surfaces of the inner layer of the uterus (endometrium) is called Asherman’s syndrome. These adhesions can lead to changes in menstrual flow or to infertility.
· Septums: A septum is a malformation of the uterus present from birth, which is associated with recurrent miscarriages or infertility. The septum is cut using hysteroscopic surgery, and the uterus easily restores to its normal state.
· Abnormal bleeding: Detection and treatment of the causes of excessive and severe menstrual bleeding is possible with hysteroscopy. It is possible to reduce the menstrual flow through endometrial ablation in women who do not plan to get pregnant.
· Essure: With the Essure, the connection between the Fallopian tubes and the uterus is mechanically blocked. This practice, which is used as a form of permanent birth control, is performed under anaesthesia in our clinic. In about half an hour, patients can return to their normal lives.
· It can be used to detect and treat the cause of recurrent miscarriages and recurrent IVF failures.

Before and After hysteroscopic surgery

Diagnostic hysteroscopy is performed without anaesthesia or with local anaesthesia. After the procedure, the patient usually does not feel pain and go back home. Operative hysteroscopy is performed under anaesthesia. Therefore, the patient must fast (no eating or drinking) for at least 6 hours prior to surgery. Since the procedure is performed under anaesthesia, the patient does not feel any pain or discomfort.

During hysteroscopic surgery, a speculum is inserted into the vagina. A 3-5mm-thick hysteroscope is inserted into the uterus from the cervix. The uterus is inflated with using CO2 gas or special fluids. The image obtained via the hysteroscope is transferred to a monitor and surgery is performed by following the operation on the screen.

Following the procedure, the patient can go back to her daily life the same or the next day. The day following the procedure, there might be mild cramps or light vaginal bleeding. Medication should not be used without the recommendation and knowledge of the doctor, and sexual intercourse should be avoided until full recovery.

If you experience any of the following symptoms after hysteroscopy, consult your doctor immediately:

· Heavy vagina bleeding
· Foul-smelling or heavy vaginal discharge
· Severe abdominal pain · Fever

Does Hysteroscopy increase the success rates of IVF?

Endometrial receptivity is important in order to achieve a successful pregnancy after an IVF treatment. Problems such as stenosis in the cervix, septum, polyps in the uterus, fibroids and adhesions may prevent the embryo from implanting. Hysteroscopy allows the diagnosis and treatment of such problems; therefore increasing the success rate of IVF treatments. When necessary, we perform hysteroscopy in our centres and achieve successful results.

What are the pros of hysteroscopic surgery?

When performed by an expert, hysteroscopy is a safe procedure. The pros of hysteroscopy can be listed as follows:

· Hysteroscopy is an outpatient procedure; the patient is discharged after the procedure.
· It is one of the most effective and reliable solutions for intra-uterine diseases.
· Postoperative pain and discomfort are minimal. · It is a definitive form of treatment especially in the removal of septums, fibroids and polyps.

Hysteroscopic surgeries rarely include the following risks: uterine perforation, cervical injury, excessive bleeding, infection of the uterus (endometritis), and complications related to anaesthesia.

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