Operative hysteroscopy (polyp, septum, fibroid)

Operative hysteroscopy treats abnormalities inside the womb through the natural passages. A hysteroscope slightly wider than the diagnostic one is passed through the vagina and cervix; it carries fine instruments used to remove or divide the lesion under direct vision. There is no scar on the abdomen. The most common procedures are removal of a polyp from the lining, removal of a fibroid that bulges into the cavity (submucosal fibroid), division of a uterine septum and release of adhesions. Any tissue removed is always sent for analysis. The operation takes place in the operating theatre, under a short general anaesthetic or a spinal anaesthetic. These lesions can cause heavy periods, bleeding between periods or after the menopause, difficulty conceiving or miscarriage. Treating them by hysteroscopy preserves the womb and the possibility of pregnancy, with a quick recovery. At Clinique Pasteur Tunis, operative hysteroscopy is carried out as a day-case procedure in a modern operating theatre. Before the operation, the gynaecologist explains what is planned; afterwards, what was done and the recommended follow-up.