Understanding Hysteroscopy

IN THE PAST, GYNAECOLOGISTS USED TO PERFORM A PROCEDURE KNOWN AS dilation and curettage (D&C) where the doctors would introduce a curette into the womb and scrape the lining off the walls of the womb. This procedure was performed “blind” as the doctors - lacking the sophisticated tools of modern medicine - were unable to see into the womb; the doctor could only hope that any abnormal tissue would be dislodged by the curette and subsequently removed for testing in the laboratory.

Advances in medical science, specifically in optical and video technology has reduced the role of D&C significantly. In most instances hysteroscopy offer a superior method of assessing uterine problems and when necessary the ability to take samples of any abnormal tissue to send to the laboratory for testing. This is done with pin point accuracy rather than scraping the uterus blindly.

Hysteroscopy is performed to establish the cause of abnormal uterine bleeding in women in the reproductive age group. Direct visualisation of the inside of the uterus (after indirect visualisation as with ultrasound, radiological techniques and Magnetic Resonanace Imaging, MRI) allows us to make a definitive diagnosis: that is, know for certain what the problem is. Once the problem is defined the solution can be offered at the same sitting. Pathology such as endometrial polyps, fibroids and synaechae (a form of adhesions) can be treated immediately by introduction of specialised scissors, graspers ,electrical devices or even lasers to completely remove the pathology.

D&C is to hysteroscopy what comparing carpet bombing during World War 2 is to the precision missiles used in the Gulf War.