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McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
Illustration
Therapeutic Hysteroscopy for Endometrial Ablation
What is a hysteroscopy?
A hysteroscopy is a procedure in which the doctor uses a
hysteroscope to look at the inside of your uterus. A
hysteroscope is a thin tube with a tiny camera. The uterus
is the muscular organ at the top of the vagina. Babies
develop in the uterus, and menstrual blood comes from the
uterus. The doctor can guide a tool into the uterus to
remove the uterine lining.
When is it used?
This procedure may be performed when you have consistent
bleeding from the uterus even after trying other treatments
to control it. You may have too much growth in the lining
of your uterus, or your ovaries may not be working well.
Examples of alternatives to this procedure are:
- hormone therapy
- having a D&C (dilation and curettage), in which the
doctor opens the cervix and scrapes or suctions tissue
from the uterus
- removing the uterus (hysterectomy)
- choosing not to have treatment, recognizing the risks of
your condition.
You should ask your doctor about these choices.
How do I prepare for a therapeutic hysteroscopy?
Plan for your care and recovery after the procedure,
especially if you are to have general anesthesia. Allow for
time to rest and try to find other people to help you with
your day-to-day duties.
Follow instructions provided by your doctor. No special
preparation is needed for local or regional anesthesia. If
you are to have general anesthesia, eat a light meal, such
as soup or salad, the night before the procedure. Do not
eat or drink anything after midnight or the morning before
the procedure. Do not even drink coffee, tea, or water.
What happens during the procedure?
You are given a local, regional, or general anesthetic. A
local or regional anesthetic numbs part of your body while
you remain awake. It should keep you from feeling pain
during the procedure. A general anesthetic relaxes your
muscles, puts you to sleep, and prevents you from feeling
pain.
The doctor dilates (opens) your cervix. The doctor guides a
hysteroscope through the cervix into the uterus. The uterus
is then inflated with fluid or gas. (This allows the doctor
to look at the inside of your uterus more closely.) The
doctor uses a laser or an electrocautery resectoscope to
remove or destroy the lining of the uterus.
What happens after the procedure?
You may stay in the hospital several hours or overnight.
After the procedure you may:
- feel sleepy or groggy from the anesthetic
- have some cramps
- have trouble urinating the first few hours after the
procedure
- have a watery or bloody discharge for 3 or 4 weeks.
After this procedure you cannot give birth to children.
If you have concerns about this, discuss them with your
doctor.
Ask your doctor what steps you should take and when you
should come back for a checkup.
What are the benefits of this procedure?
Bleeding from the uterus should stop because the lining of
the uterus is removed. This happens without having
to undergo the discomfort, hospitalization, expense, and
longer recovery of a hysterectomy.
What are the risks associated with this procedure?
- There are some risks when you have general anesthesia.
Discuss these risks with your doctor.
- A local or regional anesthetic may not numb the area
quite enough and you may feel some minor discomfort.
Also, in rare cases, you may have an allergic reaction to
the drug used in this type of anesthesia. In most cases,
local or regional anesthesia is considered safer than
general anesthesia.
- Some blood vessels in the lining of the uterus may leak.
- You may have infection or bleeding.
- Rarely, the uterus could be punctured and need surgery to
repair it.
- The bowel or bladder may be injured.
You should ask your doctor how these risks apply to you.
When should I call the doctor?
Call the doctor immediately if:
- You start to bleed a lot (like a menstrual period).
- You develop a fever.
- You have a lot of pain in your lower abdomen.
Call the doctor during office hours if:
- You have questions about the procedure or its result.
- You want to make another appointment.
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