Re: Hysteroscopy/Judith

[Guest guest]

In response to " judithstoddard " stodhord@... " post...

Hello Judith is it?

I have had three of the in-office hysteroscopy exams and three hysteroscopic

resection surgeries. I had quite a crop of submucosal fibs that were

removed last fall. I hope I can answer your questions as thoroughly as you

need.

1. " Have any of you had the in-office procedure with just local anesthesia?

What was it like? "

A: Yes, I had this procedure on my second visit with my new reproductive

endochrinologist(RE)to see just how badly my submucosal fibs were distorting

my uterus. There was no anesthesia, I took some ibuprofin before the apt to

lessen the discomfort. I had a very mild cramping sensation (of the uterine

muscles) when the saline solution was injected into the uterus. Some women

do experience mild pain. But most women can tolerate the 3mm scope that is

inserted through the cervix and into the uterus. Your doctor may give you

pills (prior to the exam day) to insert into your vagina four hours before

the exam that help dilate your cervix for the test. If memory serves me

correctly, the pills were called Citotec (not sure on spelling.)

After the saline is injected, the scope is inserted and you and your doctor

will be able to see the endometrial cavity on a monitor. Your doctor should

be able to see your follopian tubes, the fundus, and whatever is abnormal,

such as a fibroid, with better quality images than an intravaginal

ultrasound or a sonohysterogram ultrasound.

2. " Am I being reasonable or being paranoid in preferring diagnosis

first, even if it means a second operative procedure later? I'm not

sure I want to authorize my doctor to take whatever further steps

he deems necessary without knowing what they will be. "

A: You have every right to know what will take place during any surgical

procedure. I completely agree with your feelings on that. I had the

in-office hysteroscopy exam before my first resection surgery, another after

my second resection, and a final exam following my third resection to be

sure everything had been removed. My doctor used this test to diagnose the

progress of my fibroid treatment. After each surgery he found more fibroids

during the office exams because these fibs had been under pressure from the

larger ones he removed and were unseen in the first exam. So it was very

important that he could view what was left after each surgery so that both

he and I knew what was to happen next.

For the actual surgeries, I was given the option to choose either an

epidural or a general anesthetic, can you request this as well? Would you

prefer to be aware of the surgical environment so you can ask questions and

see what your doctor removes during the procedure?

If you have a large submucosal fibroid or several fibs in your uterus your

doctor may not be able to see them all with an in -office hysteroscopy exam.

Your doctor will get a better idea of what is plagueing you, but if yur

uterus is quite distorted from the fibs, the in-office test will only allow

your doctor to rule out other disorders. My doctor was able to see my fibs

during my first office hysteroscopy, but he was not entirely sure how many

fibs I had as well as how many resection surgeries it would take to remove

them completely. so I can understand why your doctor wants to perform a

sort of " exploratory " resection surgery. But if you need more information,

do request the office exam first. Make sure you understand the difference

between...

Hysteroscopy Exam: saline is injected into the uterus, a scope is inserted

through the cervix and into the uterus allowing you and your doctor to view

the endometrial images on a monitor.

Best view.

Sonohysterogram: saline is also injected into the uterus, but only an

intravaginal ultrasound device is used to view the uterus. This does not

pass through the cervix, it is vaginal only.

Moderate view.

Intravaginal ultrasound: no saline is used, only lubricant to inject the

ultrasound into the vagina.

Fair view.

If there is any risk of you being pregnant, a hysteroscopy exam and a

sonohysterogram are not the tests for you. They will not inject saline in

your uterus if there is any risk of an embryo being compromised.

Yes, do seek out the diagnosis first. If your doctor will not agree to

this, find another doctor who will. RE specialists often work in fertility

centers. it is not necessary that you be TTC (trying to conceive) to see a

doctor of fertility. They help all women who want to preserve their uterine

function.

Glad you are taking charge of your treatments. Tell your doctor you need

more information and a diagnosis before you go under the knife. It will

give you peace of mind that a surgery is the best choice for you. And if

you do opt for a hysteroscopic resection, know that it is a fast surgery,

has minimal pain and discomfort, and has a very short mending period (days

instead of weeks.)

Best wishes my dear,

:)Sonja