Hysteroscopy Definition and Patient Experiences

Definition

Diagnostic Hysteroscopy - Hysteroscopy is a procedure that uses a telescopic instrument called a hysteroscope. In this procedure, the doctor dilates the cervix and then inserts the hysteroscope into the uterus for viewing the inside of the uterus, the lining of the uterus and the fallopian tubes. The modern hysteroscopes are so tiny that they allow the visualisation with minimal or no dilation. This procedure can be done under local or general anesthesia.

Operative Hysteroscopy - This procedure uses a hysteroscope that has channels in which the doctor inserts very thin instruments. These instruments may be used to remove polyps, to cut adhesions, and do other procedures. This procedure is usually performed under general anesthesia.

Medical Definition

Hysteroscopy – inspection of the interior of the uterus with an endoscope.**

Hysteroscope – an endoscope used in direct visual examination of the canal of the uterine cervix and the cavity of the uterus.**

Endoscope – an instrument used for direct visual inspection of hollow organs or body cavities. (…) Although the design of an endoscope may vary according to its specific use, all endoscopes have similar working elements. The viewing part (scope) may be a hollow metal or fiber tube fitted with a lens system that permits viewing in a variety of directions. The endoscope also has a light source, power cord, and power source. Accessories that might be used with an endoscope for diagnostic or therapeutic purposes include suction tip, tubes, and suction pump; forceps for removal of biopsy tissue or a foreign body; and electrode tip for cauterization. *

* B. F. Miller and C. B. Keane.Encyclopedia and dictionary of medicine, nursing and allied health. Second Edition. Philadelphia: Saunders, 1987 
** Dorland's illustrated medical dictionary. 28th Edition. Philadelphia: Saunders, 1994.

Patient experiences of Hysteroscopy

First Experience:

1. Did you have to do anything prior to the procedure?
“No food starting the midnight before the laparoscopy. Can’t remember what I did for the hysteroscopies, I think I just skipped breakfast. My first doctor gave antibiotics starting the day before the procedure, but my second doctor started them the day of the procedure.”

2. Was the procedure performed at a hospital?
“My hysteroscopy/laparoscopy was performed in a hospital, but the procedures that were hysteroscopy-only were performed in the doctor’s office.”

3. Was it a day procedure or did you need to stay in the hospital?
“All were outpatient procedures. Did not stay in hospital.”

4. How long did the procedure last?
“The hysteroscopies lasted half an hour at most, but the combined lap/hyst took longer I think.”

5. What did happen immediately afterwards?
“I talked to the doctor and then went home and rested for a few hours.”

6. Did you experience any reactions after the procedure? Pains?
“Fast heartbeat for a couple hours due to anaesthesia. A little pain at the site of the laparoscopy incisions, but no pain after the hysteroscopies except sometimes a little cramping.”

7. Did you have to do or avoid anything specific after the procedure?
“No driving until the day after the procedure, because of the anaesthesia. No strenuous exercise the day of the procedure. After my first two procedures I had the balloon in for a week, so obviously no intercourse and no swimming and no tub baths. After the last three procedures I had no balloon (different doctor) so I didn’t have those restrictions. My first doctor gave antibiotics the day before, of, and after the procedure (3 days total). My second doctor gave antibiotics the day of the procedure and for two days afterwards (3 days total). Both doctors prescribed estrogen for a month after the procedure, followed by progesterone to bring on a period.”

8. Did you need to stop your daily routine/ or take days off from work? 
“After the laparoscopy I took a week off from work although I actually felt fine after a couple of days; I was just worried about healing properly; but taking the whole week off was probably not necessary. For the hysteroscopies I only took off the day of the procedure, and that was mostly because I needed time to recover from the anaesthetic, not the procedure itself; after the last couple of hysts, I worked from home in the afternoon.”

“Some doctors give general anaesthesia for hysteroscopies but for mine I was awake. (Although I had general anaesthesia for the laparoscopy of course.) Some doctors will videotape the procedure for you if you bring a blank videotape with you. The tape will show you exactly what the doctor was seeing through the hysteroscope.”

Second Experience:

“For my operative hysteroscopy I was asked to not eat nor drink anything from midnight on till the surgery. That’s why I asked for an early appointment (8 am). I took my detailed blood analysis with me.” 

“Upon arrival I filled out two questionnaires, one with my gynaecological story, and one for the anaesthetics about my general health. The surgery was done in a day care clinic, so I went home four hours after arrival. Shortly before the surgery I had to get undressed (totally, no make-up, no nail polish, no rings etc.) and got a linen surgery gown (those which are open in the back and make you walk with your hands holding it together in the back…).”

“I walked into the theatre with a nurse, took my seat (how I love this position…) and was put to sleep by an injection. The surgery took 45 minutes. I woke up in a bed in the waking up room, a glucose drip was fastened to my hand. I felt dizzy but fine. The doctor told me about the results half an hour later and even though I thought I perfectly understood him at the time, I forgot everything after going to sleep again. So it was good I had another appointment a day later when he could go over the results with me being nearly back to normal. After the surgery I got as much peppermint tea as wanted and was told that if I felt fine I could try to go to the toilet. As soon as I managed this without the nurse’s help and as soon as my blood pressure looked normal, I was allowed to go. This was roughly two hours after the surgery. I had to have someone accompany me home. My husband was waiting for me and I even felt like taking a short stroll around the city before actually heading home. All I could feel was some sort of heavy burden in my shoulders, a result of the gas with which the surgeon had dilated the uterus and which touched a nerve in the abdomen. I took off another two days after the surgery and was more tired the day after the surgery than the actual day. But I had no more pain and the light bleeding after surgery subsided quickly. No surgery is a walk in the park but this was the easiest one I have ever had.”

Third Experience: 

“Hysteroscopy/Laparoscopy – I had both of these done. It was outpatient surgery at the hospital. My surgery was about 3 hours, but this was longer than most, some could be less time. I had surgery on a Monday, and had to do the preparation on Sunday. I think the prep was the worst. Because I had the laparoscopy, I had to do bowel preparation the day before. I was able to have a light breakfast on Sunday (boiled egg, white toast, no butter), and then the rest of the day only clear liquids (broth, jello, etc). Had to do the Fleet bowel cleansing system. Which basically cleans you out, so by the end of the day, it’s just water coming out. Not a fun day, basically have to spend a lot of time on the toilet with diarrhea. Post surgery, I had no problems. The nurse said I must have taken her advice and drank a lot of water on Sunday, because I did well in the post-surgery recovery. I did not need to take any of the narcotic pain relief they prescribed. I did take Motrin – 600mg tablet (which they prescribed), early on Tues morning, and once on Wed after the surgery.” 

“I took 7 days off from work. I wanted to go back the next Monday, but my doctor said if I could, to stay home until I had my post surgery check up the following Tues. I think I could have returned to work the following Monday, but I took his advice just to be sure.”

“I did not have to take any medications/hormones/antibiotics after the surgery.”

Fourth Experience: 

Operative Hysteroscopy
1. Did you have to do anything prior to the procedure?
“Fasting(12hrs)-just like any other surgery.”
2. Was the procedure performed at a hospital?
“In the doctor's office”
3. Was it a day procedure or did you need to stay in the hospital?
“Day procedure - probably about 2 hours total with prep and recovery”
4. How long did the procedure last?
“1 hour”
5. What did happen immediately afterwards?
“I was a little woozy from the local anaesthesia. But it did not take me long to be walking around in the doctor's office. I went back to my hotel room and slept for about 30 minutes and felt completely fine after that.”
6. Did you experience any reactions after the procedure? Pains?
“The procedure was completely painless, and I never felt anything during or after the surgery. However, I was given antibiotics and threw up the first dose. I did take it with a meal as directed, but it maybe was not a big enough meal since I had been fasting.”
7. Did you have to do or avoid anything specific after the procedure?
“Avoid sex for 3 days.”
8. Did you need to stop your daily routine/ or take days off from work? 
“How many days did you take? Since I went out of town for surgery, I spent one day travelling, 1 day for surgery, 1 free day and 1 day to travel again. The doctor does not like people to fly on the same day of surgery, but my guess is I would have been well enough. But it's best to be cautious. If the procedure is done in your local area, I would imagine that you'd only need to take that one day off.”

Fifth Experience: 

“2 Hysteroscopy/laparoscopy (both under general anaesthetic), fasting required due to general anaesthetic. Both performed at hospitals, first time in Wednesday, surgery Wednesday afternoon home next day. Second time (included laser treatment for endometriosis) in Wednesday, surgery Wednesday evening home Friday morning (I was quite sick after anaesthetic and the laser treatment was a bit more invasive). Had to avoid exercise for a week or two, had a couple of days off work for first surgery, second one was 2 weeks off work.”

“1 Hysteroscopy under general anaesthetic (about 1 hour), fasting for general anaesthetic, performed at Day Clinic (in Germany), in and out same morning but told to rest for the next couple of days. Went back to work following week (surgery was on Tuesday). Started hormone pills the day after the surgery. Flew back to the UK on Thursday (uncomfortable sitting upright for so long, but bearable).”

“1 in office hysteroscopy (about 30 mins) - performed in endoscopy suite at hospital did not have to fast, local anaesthetic injections inside were painful, however went home next day and could work following day.”

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