What is a Hysteroscopy?
Hysteroscopy is the inspection of the uterine cavity using a thin camera inserted through the vagina and cervix. Hysteroscopy allows for direct visual examination with greater magnification and accuracy than any other method (eg ultrasound, CT or MRI, etc). Any abnormalities found (eg hyperplasia, polyps, fibroids, adhesions, septum, etc) can be treated immediately (invasive hysteroscopy).
A diagnostic or micro-invasive hysteroscopy is carried out under local anesthesia whereas an invasive hysteroscopy is carried out under local or mild general anesthesia. The patient may need stay in the hospital for 1 to 24 hours, depending on the case.
The Hysteroscopy Centre at St Luke's hospital was established in 1999 by Dr Elias Tsakos and his medical team. Since then, they have successfully performed more than 1000 hysteroscopies. The results of their experience (safety and efficiency) has been presented in many Greek and International Conferences.
Hysteroscopy and Uterine Bleeding
Uterine hemorrhaging occurs in about 20% of women, either as heavy blood loss or as erratic bleeding at various stages of the menstrual cycle. In most cases, especially in women over the age of 35, the hemorrhaging may be due to conditions such as endometrial polyps, hyperplasia and fibroids. The risk of endometrial cancer increases with age and early diagnosis is of particular importance in women over 45-50 years old.
In most cases, hysteroscopy allows for immediate diagnosis and the simultaneous treatment of the problem.
Hysteroscopy & Hyperplasia - Polyps - Fibroids
Hyperplasia is the enlargement of the endometrium usually due to hormonal or idiopathic causes, although, rarely, it may conceal a malignancy.
Polyps and fibroids (submucosal) are tumors of the endometrium or, more rarely, of the endocervix.
Patients with these problems usually experience bleeding and/or infertility, although sometimes these problems are discovered incidentally during screening. They are usually benign but malignancy can be excluded only after a histologic examination (biopsy), hence requiring complete removal with invasive hysteroscopy.
Hysteroscopy and Endometrial Adhesions
Endometrial adhesions are the presence of scar tissue in the endometrium created after injury (curettage, miscarriage, intrauterine spiral) or inflammation of the endometrium.
Endometrial adhesions are usually responsible for hypomenorrhea (extremely light menstrual blood flow), infertility and miscarriages.
Hysteroscopy is the only reliable method for diagnosing endometrial adhesions.
Hysteroscopy and Infertility
During a hysteroscopy, the endocervix and endometrium is examined in detail.
Today, it is imperative that hysteroscopy is carried out in cases of unexplained infertility, IVF failure and miscarriage.
Moreover, a hysteroscopy is always done in infertility patients undergoing a laparoscopy.
The beneficial effects of Hysteroscopy on Infertility were presented by the Centre's Medical Team at the 2nd National Conference on Fertility (Thessaloniki, December 2002).
Hysteroscopy and Cancer
Uterine bleeding is one of the first symptoms of endometrial cancer, the incidence of which increases with age.
A hysteroscopy and histologic examination (biopsy) are the only reliable methods of diagnosing endometrial cancer, the early treatment of which is often of great importance to the patient.
Hysteroscopy and Prevention
Some women present with an increased risk of hyperplasia, polyps and endometrial cancer. Risk factors include conditions such as obesity, diabetes, polycystic ovarian syndrome, treatment with tamoxifen for breast cancer and a history of endometrial hyperplasia or polyps.
In these women, diagnostic hysteroscopy is recommended for early diagnosis and treatment.
Questions & Answers
Will I feel pain after the hysteroscopy?
The postoperative discomfort is negligible, similar to period pain, lasts 1-2 days and can be treated with simple painkillers.
Will I be bleeding? For how many days after the hysteroscopy?
Small vaginal bleeding occurs for 1-2 days after diagnostic hysteroscopy and 1-3 weeks after invasive hysteroscopy.
When can I return to work?
Most women return to work the following day after a diagnostic hysteroscopy and 2-3 days after an invasive hysteroscopy.
What are the possible complications and how frequent are they?
Surgical complications such as uterine injury, hemorrhaging, fluid overload and inflammation occur in less than 1% of cases. Complications of anesthesia are extremely rare, occurring in less than 1 in 1000 cases and are usually negligible. Hysteroscopy is a very safe procedure, provided that it is performed by an experienced medical team supported by modern equipment.
Is the cost of hysteroscopy covered by my insurance plan?
The majority of public health insurance plans cover a portion of the expenses. The overall cost is significantly reduced due to the short hospitalization and rapid recovery time with the patient returning to work quickly.
The Gynaecology & Fertility Center provides specialized services in Gynaecology, Obstetrics, Endoscopic Surgery, Infertility and Breast.
Head of the Centre is Dr Elias G. Tsakos MRCOG, CST Obstetrician Gynaecologist, trained and certified in England.
We aim at individualized treatments and evidence-based medicine with honesty, respect and care.
Our services are fully computerized and patients are electronically registered in safe and secure systems. Cutting edge medical technology is used and current medical protocols applied in accordance to the latest guidelines.
Our Centre is open daily, Monday - Friday, 9 am - 9 pm.
We also provide 24 hour Medical support for emergencies. |
