Reasons for Diagnostic Hysteroscopy
Investigation of excessive vaginal bleeding (menorrhagia)
The causes of uterine bleeding is different for each age category:
- The appearance even of a small amount of blood from the vagina in women over fifty years old, who have stopped their periods for a long time, deserves attention and investigation to exclude the possibility of endometrial cancer. The vast majority of all these women will prove after extensive testing will not have cancer. Hysteroscopy in combination with a diagnostic curettage will be able to offer this assurance. The small minority of women who will eventually be diagnosed with endometrial cancer in most cases will be in very early stages. With proper treatment it is possible that these women will be fully healed.
- In women under forty years old the possibility of endometrial cancer is extremely rare and usually hysteroscopy is performed only when excessive vaginal bleeding does not respond to medical therapy. In this case hysteroscopy will investigate the possibility of other causes of the problem such as fibroid polyps of the uterus.
- For ages between forty and fifty hysteroscopy may be performed in women who had normal periods while suddenly exhibit vaginal bleeding between periods or unusually heavy blood loss during the period. The hysteroscopy will provide the opportunity for direct optical investigation of the uterine cavity and in combination with some curettage of the endometrium will be able to set the diagnosis or exclude any pathology of the uterine cavity safely.
Investigation of infertility causes
Hysteroscopy has proven to be a useful method of investigating the causes of infertility in a woman. The cavity of the uterus in some women is not regular because of the presence of a genetic diaphragm of the uterine cavity (a tissue membrane which divides the cavity of the uterus in two portions). Sometimes it is possible for the uterine cavity to be occupied in a greater or lesser extend by fibroids or by adhesions. These conditions may contribute to some extent to infertility in a woman. In this case hysteroscopy is the gold-standard method of diagnosis and often can be corrected by operative hysteroscopy.
Cases where Operative Hysteroscopy is used
By the use of suitable hysteroscope it is possible to introduce in the uterine cavity fine instruments such as fine surgical scissors, forceps, laser, loop (resectoscope) etc. and under direct vision of the uterine cavity to perform an extensive number of minor operations. Operations that can be performed by hysteroscopy are removal of polyps, fibroids, and diaphragms and cauterization of the endometrium to treat menorrhagia.