Gynaecological endoscopy is a surgical discipline which uses optical instruments specially designed to help diagnose the most frequent female disorders and pathologies such as for example some infertility problems, small vaginal haemorrhages or endometrial polyps.

You may be familiar with terms like laparoscopic surgery or “keyhole” surgery. These are minimally invasive procedures that utilize an endoscope to reach internal organs through very small incisions. Endoscopic surgery is a minimally invasive surgery.

This is an alternative to open surgery which requires a large incision. Laparoscopy generally has a shorter healing time than open surgery. Patients can benefit from reduced hemorrhaging, less pain, less post-operative scarring and speed recovery.

Gynaecological endoscopy employs hysteroscopy and laparoscopy.

Laparoscopic is for seeing inside the abdomen

It can be used to diagnose or treat:

• Infertility
• Endometriosis
• Pelvic adhesions
• Pelvic inflammatory disease

Hysteroscopy is seeing inside the uterine cavity

It can be used to diagnose or treat:

• Bleeding disorders
• Polyps within the uterine cavity

A gynecologist, general surgeon, or another type of specialist certified in endoscopy may perform this procedure.

This kind of surgery can be used for diagnosis, treatment, or both. A diagnostic procedure can sometimes turn into treatment.

Some reasons for diagnostic procedures are:

• unexplained pelvic pain
• unexplained infertility
• a history of pelvic infection

Conditions that might be diagnosed using endoscopy include:

• endometriosis
• uterine fibroids
• ovarian cystsor tumors
• ectopic pregnancy
• pelvic abscess, or pus
• pelvic adhesions, or painful scar tissue
• infertility
• pelvic inflammatory disease
• reproductive cancers

Some types of endoscopic treatment include:

• hysterectomy, or removal of the uterus
• removal of the ovaries
• removal of ovarian cysts
• removal of fibroids
• blocking blood flow to fibroids

• • endometrial tissue ablation, which is a treatment for endometriosis 
  • adhesion removal
  • reversal of a contraceptive surgery called tubal ligation
  • Burch procedure for incontinence
  • vault suspension to treat a prolapsed uterus

The doctor will dilate (widen) your cervix to allow the hysteroscope to be inserted. The hysteroscope is inserted through your vagina and cervix into the uterus. Carbon dioxide gas or a liquid solution is then inserted into the uterus, through the hysteroscope, to expand it and to clear away any blood or mucus.

Is hysteroscopy painful?

The procedure shouldn’t be painful. However, you may experience some cramping during the procedure. Your doctor may order some type of sedative for you to take beforehand so that you’ll be more relaxed. The extent of anesthesia you need will depend on the purpose of your hysteroscopy

These symptoms usually go away in 1 or 2 days After the procedure, you may have some cramping or slight vaginal bleeding for one to two days. In addition, you may feel shoulder pain if gas was used during your hysteroscopy.. If the doctor filled your uterus with liquid during the procedure, you may have watery vaginal discharge for a few days. Many women are able to return to work on the day after the procedure. But it depends on what was done during the procedure and the type of work you do.

After surgery, it is normal to have a sore belly, cramping, or pain around the cuts the doctor made (incisions) for up to 4 days. You can expect to feel better and stronger each day, although you may get tired quickly and need pain medicine for a few days.

Skin irritation and bladder infection are common side effects of this procedure.

More serious complications are rare. However, they include:

• damage to an abdominal blood vessel, the bladder, the bowel, the uterus, and other pelvic structures
• nerve damage
• allergic reactions
• adhesions
• blood clots
• problems with urinating

Conditions that increase your risk of complications include:

• previous abdominal surgery
• obesity
• being very thin
• extreme endometriosis
• pelvic infection
• chronic bowel disease

The gas used to fill the abdominal cavity can also cause complications if it enters a blood vessel.

Pay close attention to your body during the recovery period. Write down any side effects you’re experiencing and discuss them with your doctor.

Serious complications of laparoscopy are rare. However, you should call your doctor if you have:

• serious abdominal pain
• prolonged nausea and vomiting
• fever of 38,3°C or higher
• pus or significant bleeding at your incision site
• pain during urination or bowel movements.