An office hysteroscopy is conveniently performed in a physician’s office under local anesthesia. Numbing medication is injected into the cervix and a very thin camera is guided into the uterine cavity.
This procedure can identify abnormalities involving the uterine cavity:
- Intrauterine fibroids
- Intrauterine adhesions
- Endometrial polyps
- Masses suspicious for malignancy
A small biopsy can be performed during the evaluation to rule out malignancy. If a fibroid or intrauterine adhesions are found, operative hysteroscopy under IV sedation in the operating room will be required.
Operative Hysteroscopy is used to remove intrauterine growth (fibroid or polyp), uterine septum, or adhesions.
An operative hysteroscopy is performed in an operating room under IV sedation administered by an anesthesiologist. During the procedure, the cervical canal is dilated and a larger-caliber camera (scope) is guided into the uterine cavity. The uterine cavity is distended with fluid and a heated loop device is then used to cut away the fibroid (hysteroscopic myomectomy), polyp, septum or adhesions.
In cases of large fibroids, uterine septum, or extensive adhesions, several procedures are required for complete removal and should be performed by an experienced surgeon to avoid complications. One of the risks of operative hysteroscopy is the formation of intrauterine adhesions. In some cases, an intrauterine balloon is placed at the completion of the procedure to decrease bleeding and prevent scarring. The balloon is removed in the office after seven days, and the patient is prescribed high-dose estrogen for several weeks to rebuild a healthy uterine lining and further prevent the formation of intrauterine adhesions.
Hysteroscopy D&C is usually performed to evaluate the cause of abnormal uterine bleeding and most importantly to rule out malignancy in post-menopausal patients.
D&C is an abbreviation for Dilation and Curettage, which refers to the dilation of the cervix and scraping (curettage) of the uterine lining. This procedure is performed under anesthesia in the operating room.
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