Hysteroscopy
Hysteroscopy is direct visualisation of the uterine cavity with a narrow telescope. Whereas laparoscopy shows the outer surface of the uterus, tubes and ovaries and other abdominal and pelvic organs, hysteroscopy shows the cervical canal, structure of the uterine cavity and tubal openings.
Assessment with HSG and ultrasound provides additional structural information, but direct visualisation procedures allow surgical corrections to be performed. Real time pictures and videos of the uterine cavity and tubal patency tests can be performed, with visualisation of the flow of fluid through the tubal openings.
Various anomalies of the uterine cavity may exist and be associated with inability to conceive or recurrent miscarriages.
Hysteroscopic surgery can be performed to correct some anomalies that are detected. Usually an IUD (intrauterine device) is placed inside the uterus for 3-4 months to prevent adhesions between the walls of the uterus.
Uterine Septum
A frequent cause of failure to implant may be due to the presence of a fundal septum. The septum is usually fibrous, resulting in poor blood supply. Resection of the septum results in better blood supply, increasing the chance of implantation and a successful pregnancy outcome.
Uterine Fibroids
The site of uterine fibroids may affect pregnancy outcomes. In general, fibroids affect the blood flow to the uterine muscle, with the intracavity or submucous fibroids associated with implantation failure and miscarriages. Removal of these fibroids is necessary, while removal of fibroids in other sites requires more detailed discussion between you and your gynaecologist.
Uterine Polyps
These may have the same effect as the submucous fibroids and require removal.
Ashermann’s Syndrome
In Ashermann’s syndrome, various scenarios are present. The uterine cavity may be completely obliterated or contain a few too many adhesions. In extreme cases, despite hysteroscopic intervention, it may not be possible to achieve a large enough cavity to maintain a full term pregnancy.
Lost IUCDs
When the strings of the IUD are not visible through the cervix, hysteroscopy may often be required to retrieve the IUD. Occasionally the IUD is embedded in the uterine wall or sometimes erodes through it. In these cases, laparoscopy may be combined with hysteroscopy to repair the defect in the uterus after removal of the IUD.
Assessment with HSG and ultrasound provides additional structural information, but direct visualisation procedures allow surgical corrections to be performed. Real time pictures and videos of the uterine cavity and tubal patency tests can be performed, with visualisation of the flow of fluid through the tubal openings.
Various anomalies of the uterine cavity may exist and be associated with inability to conceive or recurrent miscarriages.
Hysteroscopic surgery can be performed to correct some anomalies that are detected. Usually an IUD (intrauterine device) is placed inside the uterus for 3-4 months to prevent adhesions between the walls of the uterus.
Uterine Septum
A frequent cause of failure to implant may be due to the presence of a fundal septum. The septum is usually fibrous, resulting in poor blood supply. Resection of the septum results in better blood supply, increasing the chance of implantation and a successful pregnancy outcome.
Uterine Fibroids
The site of uterine fibroids may affect pregnancy outcomes. In general, fibroids affect the blood flow to the uterine muscle, with the intracavity or submucous fibroids associated with implantation failure and miscarriages. Removal of these fibroids is necessary, while removal of fibroids in other sites requires more detailed discussion between you and your gynaecologist.
Uterine Polyps
These may have the same effect as the submucous fibroids and require removal.
Ashermann’s Syndrome
In Ashermann’s syndrome, various scenarios are present. The uterine cavity may be completely obliterated or contain a few too many adhesions. In extreme cases, despite hysteroscopic intervention, it may not be possible to achieve a large enough cavity to maintain a full term pregnancy.
Lost IUCDs
When the strings of the IUD are not visible through the cervix, hysteroscopy may often be required to retrieve the IUD. Occasionally the IUD is embedded in the uterine wall or sometimes erodes through it. In these cases, laparoscopy may be combined with hysteroscopy to repair the defect in the uterus after removal of the IUD.
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