Hysteroscopy
Hysteroscopy is a procedure used to visualize the inner cavity of the uterus, the tubal openings and the endometrial lining. The high definition (HD) camera is attached to the hysteroscope and the surgeon inserts a thin telescope of 2mm to 4mm in the uterine cavity through the vagina. Hysteroscopy is an excellent mode of intervention to diagnose and correct any pathology within the cavity of uterus.
Hysteroscopy surgery in Mumbai is performed at our Chembur centre. Our centre is equipped with the latest 2.9 mms Hysteroscope and we have performed Hysteroscopy surgery for various indications. All Hysteroscopy surgeries are video recorded and discussed with the patient.
It is now a standard form of surgical intervention in the infertile women who have the following problems-
- Ectopic pregnancy
- Endometriosis
- Fibroid
- Adhesions/Tubal blocks
- Polycystic ovarian disease
- Ovarian cysts
Surgeries like hysterectomy, cancer and stress urinary incontinence are also being routinely and successfully performed through the laparoscope.
There are two types of Hysteroscopy
- Diagnostic Hysteroscopy
- Operative Hysteroscopy
Indications
- Infertility
- Recurrent abortions
- Excessive menstrual loss
- Absent/scanty menses
- Evaluating the cavity of the uterus before Embryo Transfer in an IVF/ICSI cycle
Operative Hysteroscopy Indications
- Intrauterine adhesions/ Ashermans syndrome – It can be a reason for failure to conceive. The adhesions inside the uterine cavity are incised with the Hysteroscopic scissors.
- Uterine polyps – it may cause heavy bleeding or infertility. They are diagnosed on sonography. Using a hysteroscope, a polyp can be easily resected.
- Fibroids – type O to type I submucous fibroid that projects into the uterine cavity can be removed hysteroscopically. These fibroids could be a cause of heavy bleeding during menses and infertility; hence they need to be removed.
- Blocked tubes – If on the HSG, the cornual are blocked then a small wire can be inserted through the Ostia to open the tube. This is performed hysteroscopically. It is called cornual cannulation. It can treat proximally blocked tubes.
- Intrauterine septum – It is the presence of curtain inside the uterus which can lead to infertility and recurrent miscarriages. A septum is diagnosed via hysteroscopy. It can be cut using scissors or a resectoscope. We have had many successful pregnancies after a septum resection performed at our centre.
- Endometrial biopsy in cases of postmenopausal bleeding to rule out Ca of the Endometrium.
- Before Embryo transfer in failed IVF cycles.
- Hysteroscopy is done through the vagina. It could be done on an Outpatient procedure.
Advantages Over Blind D & C
- Direct visualization of endometrial cavity, tubal ostia, endometrium, endocervical canal Cervix and vagina
- Diagnosis and treatment of so many pathologies
- Minimizes the risk of missing a local pathology
- THERE ARE NO STITCHES
Restrictions
Cannot assess myometrial disease and is contraindicated in active pelvic infections and in diagnosed Cervical and endometrial malignancy.
The success of ART treatment increases after a corrective surgery done through the Hysteroscope.
We at Dr Sudha Tandon’s fertility, IVF, Gynaec Endoscopy and Maternity center have all world class facilities for Hysteroscopy treatment in Mumbai.
