Surgical hysteroscopy is a gynecological procedure performed on women who have abundant uterine bleeding and whose cause has already been identified. Thus, through this procedure it is possible to remove uterine polyps, submucosal fibroids, correct changes in the cavity of the uterus and remove adhesions of the uterus.
As it is a surgical procedure, it is necessary to perform it under anesthesia, however the type of anesthesia varies according to the length of the procedure to be performed. In addition, it is a simple procedure, which does not require many preparations and has no complicated recovery.
Despite being a safe procedure, surgical hysteroscopy is not indicated for women with cervical cancer, pelvic inflammatory disease or who are pregnant.
When it is indicated
Surgical hysteroscopy is indicated by the gynecologist when the cause of profuse bleeding has been identified, and is performed for:
- Remove submucosal fibroids;
- Remove uterine polyps;
- Treat changes in the uterine cavity, such as bicornuate, unicorn, didelfo and septate uterus;
- Remove adhesions in the uterus;
- Reduce the thickness of the endometrium;
- Tubal ligation of the uterine tubes.
In addition, surgical hysteroscopy can be performed to remove the IUD when it has no visible threads.
Preparation for surgical hysteroscopy
Many preparations are not necessary to perform surgical hysteroscopy, and it is recommended that the woman be fasted due to the use of anesthesia.
In some cases, the doctor may indicate that the woman takes an anti-inflammatory pill 1 hour before the procedure and in case of thickening of the uterine canal, it may be necessary to place a pill in the vagina according to the medical recommendation.
How it is done
Surgical hysteroscopy is performed by the gynecologist and aims to treat the changes that have been identified in the uterus and, for this, it must be done under general or spinal anesthesia so that there is no pain.
In this procedure, after the administration of anesthesia, the hysteroscope, which is a thin device that contains a microcamera attached to its end, is introduced through the vaginal canal to the uterus so that the structures can be visualized. Then, to expand the uterus and allow the surgical procedure to be performed, carbon dioxide in the form of gas or fluid, with the aid of the hysteroscope, is placed inside the uterus, promoting its expansion.
As soon as the uterus acquires an ideal size, surgical equipment is also introduced and the doctor performs the procedure, which lasts between 30 minutes to 1 hour depending on the extent of the surgery. As there are no cuts to insert the necessary devices for the procedure, it is not necessary to take stitches.
How is recovery
The postoperative period of surgical hysteroscopy is usually simple. After the woman wakes up from anesthesia, she is under observation for about 30 to 60 minutes. Once you are wide awake and feel no discomfort, you can go home. However, in some cases it may be necessary for the woman to be hospitalized for a maximum of 24 hours.
Recovery from surgical hysteroscopy is usually immediate. The woman may experience pain, similar to menstrual cramps in the first few days, and blood loss may occur through the vagina, which may last for 3 weeks or until the next menstruation. If the woman feels fever, chills or the bleeding is very heavy, it is important to go back to the doctor for a new evaluation.