Diagnostic Hysterolaparoscopy is a method of diagnosis used to evaluate conditions related to infertility in the female reproductive organs. Hystero refers to the uterus, laparoscopy is a type of surgical procedure which involves the insertion of a thin fibre optic cable with a camera at the end, known as a Laparoscope. The Laparoscope is inserted through specific one of several incisions made by the doctor during the procedure. The camera feed enables the doctor to receive detailed images from inside the uterus on an external screen, the doctor uses this information to diagnose the patient. These conditions are primarily related to infertility, but an examination of the uterus may reveal several types of conditions.
Hysterolaparoscopy is used world-wide commonly and has become a reliable procedure in the diagnosis and treatment process of infertility. This is due to the fact that it provides much more detailed information on the situation inside the uterus than other imaging tests, such as ultrasound or an MRI can. Diagnostic Laparoscopy is used to diagnose several conditions, which are difficult to identify without the additional information that diagnostic laparoscopy provides. These are some of the conditions that may be causing infertility, which Diagnostic Hysterolaparoscopy can make your doctor aware of:
- Endometriosis: A condition that can cause considerable pain and discomfort, in endometriosis the tissue that lines the inside of the uterus, grows outside. Diagnostic Hysterolaparoscopy allows your doctor to identify this easily.
- Uterine fibroid: Bands of smooth muscle cells and fibrous connective tissue form as growths known as uterine fibroids. Usually harmless, depending on their size and location, these can cause infertility. Diagnostic Hysterolaparoscopy allows your doctor to diagnose and identify symptomatic fibroids, in order to extract them.
- Adhesions: Adhesions or scar tissue are bands of scar tissue that can form in the uterus. These too can cause infertility in some cases. Adhesions can be identified and handled effectively with diagnostic Hysterolaparoscopy.
- Ovarian cysts: Cysts don’t usually cause symptoms, but when they do, diagnostic hysterolaparoscopy can be used to identify them in the uterus and treat accordingly.
- Ectopic pregnancy: This is a condition in which the embryo attaches outside the uterus instead of in a normal position, this is a serious condition and can be diagnosed using hysterolaparoscopy.
- Tubal patency: Diagnostic hysterolaparoscopy can be used in order to check if the fallopian tubes are open, closed fallopian tubes will not allow an egg to travel to the uterus and may be a cause of infertility.
Diagnostic Laparoscopy is a not a major surgery, although it does require the patient to be under general anaesthesia. This means that the patient will not be conscious during the course of the surgery. The doctor may provide the patient with certain guidelines which must be strictly adhered to before the procedure, such as not consuming any fluids or food in the hours before the procedure. The steps that might be followed for your diagnostic hysterolaparoscopy is listed below:
- The patient must change into a hospital gown and remove their personal accessories before entering the operating room.
- Once positioned on the operating table, an anesthesiologist will inject the patient with general anesthesia, which will render the patient unconscious for the surgery.
- An Intravenous line may be inserted into your arm or wrist before the procedure.
- A catheter may be inserted in your vagina to collect urine during the procedure.
- An incision is made below the belly button; several other incisions may also be made on the abdomen. The location of the incision may vary from person to person.
- In some cases, doctors may use another incision to insert a cannula, this will enable the doctor to fill the abdomen with carbon dioxide gas. The gas plays the role of expanding the space inside the abdomen, giving the doctor more scope to navigate within the uterus and obtain a clearer view. It also decreases the risk of internal damage, as the carbon dioxide gas pushes the abdominal wall away from other internal organs.
- Another instrument is inserted through an alternate incision, in order to manipulate the organs into place, the doctor should get a clear view of the uterus, fallopian tubes and the ovaries.
- Often a sample tissue is taken from the uterus lining in order to further test in a lab under a microscope.
- In some cases, a fluid is injected in the cervix, uterus and fallopian tubes to determine the patency.
- Once the uterus is fully inspected, the surgical instruments and the laparoscope are removed from the abdomen.
- The incisions are stitched and bandaged, the patient may take several hours to wake up and fully recover from the effects of the anesthesia.
As is the case with any surgery, diagnostic laparoscopy carries its own risks. These are listed below:
- Infection: an infection may develop in the abdomen due to bacteria that enter during the procedure. An infection might also develop in the bladder.
- Adhesions: Scar tissue may develop within the abdomen.
- Hematomas: This is defined as an area of blood away from ruptured blood vessels.
- Uterine perforation: This may occur if one of the surgical instruments used during the procedure can cause damage to the uterus and the lining.
It is very rare for these risks to result in any serious issues from a diagnostic laparoscopic procedure and in most cases, none of these risks will carry life threatening concerns. Immediately after the procedure and for a few hours the carbon dioxide used to expand the abdomen may cause discomfort in the shoulders, chest and abdominal areas. This pain will subside as the gas leaves your body and the patient will be able to resume normal activity in a few days. The patient may also require a few hours to recover fully from the effects of the general anesthesia, patients may feel dizzy and groggy. It is advised to have someone to drop and pick you up from the location, as it is not safe to drive under the effects of anesthesia.
If the patient is experiencing severe pain in the abdomen after the surgery, it is advisable to receive immediate medical help, this may be a sign that infection has developed in the abdominal area. It is generally advised to avoid inserting anything inside the vagina or avoid any strenuous activity for a number of days post the operation. Each patients post-operative care may vary on their situation and how their procedure went. Discuss with your doctor so you have a clear idea and are well informed throughout the procedure.
Infertility can be very daunting, and the steps and procedures that a patient might have to endure in order to fight infertility are known to be testing mentally, physically and financially. Diagnostic Hysterolaparoscopy is a simple procedure, if performed at the right time can give your doctor the information they need to lay an appropriate base for your fertility treatment. The procedure may give your doctor important information which may change the way your infertility treatment Is approached. The treatment any individual might undergo differs from person to person, for infertility, gathering as much information about the uterus and other reproductive organs is a vital step.
