ABDOMINAL HYSTEROSCOPE COMPLICATIONS

A hysteroscopy is a procedure that allows doctors to look inside the womb (uterus). A hysteroscope, a thin telescope with a light and camera at the end, is used to do the procedure. Your doctor or specialist nurse can look inside your womb thanks to images delivered via a monitor. Because the hysteroscope is delivered into your womb through your vaginal and cervix, no cuts in your skin are required. As a result, a hysteroscopy is a minimally invasive technique.

Hysteroscopy Complications

Uterine perforation — Uterine perforation is the most common complication of hysteroscopy. Uterine perforation can occur during mechanical cervical dilation or insertion of the hysteroscope. Such a perforation may be recognised when an instrument passes beyond the depth of the uterine fundus, when there is a sudden loss of visualisation, when bowel or peritoneal structures can be visualised at the uterine fundus, or when there is a sudden increase in the fluid deficit. Complications of a hysteroscopy can include:

• Urinary tract or bowel injury — Bowel or bladder injury is rare but may be associated with uterine
• Cervical laceration — Cervical lacerations can occur, particularly in women with cervical stenosis. Lacerations that are large or are bleeding require sutures.
• Embolism — Embolism (air or carbon dioxide) can occur with any hysteroscopic technique and cause cardiovascular collapse.
• Haemorrhage — Potential sources of intraoperative bleeding include operative sites, uterine perforation, and cervical laceration. Bleeding from cervical lacerations that are recognised at surgery can be controlled using operative instruments.
• Electrosurgical injury — Thermal effects of radiofrequency or laser energy can cause injuries to the uterine cavity and bowel, urinary bladder, and large pelvic vessels.
• Sepsis - Sepsis generally results from unrecognised thermal bowel injury. Fistulae or urinary ascites can occur from an unrecognised bladder injury. Such complications require consultation with a colorectal surgeon, urologist, or infectious disease specialist.

Treatment

Treatment options may vary depending on the age of the woman being treated.  Treatment options include:

• Birth control can address the hormone imbalance and keep menstruation regular
• Progestin therapy may help regulate menstruation and reduce the risks of endometrial cancer.
• Hormonal treatments such as anti-oestrogen medication, insulin lowering medication, and Gonadotropins can also be considered.
• Weight loss can help regulate your menstrual cycle and hormones and reduce your risk of developing diabetes.