Q. What is a hysteroscope? A. Hysteroscopy, as the name implies, is a mirror that examines the uterine cavity, which is an optical instrument (as shown below). Hysteroscopy is a procedure where this mirror is inserted into the patient’s uterine cavity and fluid is injected to make the uterus swell up. This is where the doctor can see the shape of the uterine cavity and the lesions on the TV screen that accompanies the mirror and treat them. Q. Is there a wound during hysteroscopy? Is it a minimally invasive surgery? A. Hysteroscopy is a minimally invasive procedure. After the patient’s cervix is properly dilated, the doctor probes the hysteroscope into the uterine cavity for observation and operation. Since it is done through the natural orifice of the cervix, there is no body surface wound. Q. Hysteroscopy should be relatively simple and considered a minor surgery, right? Are there any risks involved? A. Actually, don’t underestimate hysteroscopy. Hysteroscopy is an operation in the uterine cavity, so it carries the same risks as abortion, such as cervical injury, infection, uterine bleeding and perforation. In addition, hysteroscopy has its unique risks, the most common of which is water poisoning. As we mentioned earlier, hysteroscopy requires fluid to swell the uterus in order for the procedure to go smoothly, so hysteroscopy is a procedure performed in fluid. If the operation takes too long or there is a lot of bleeding, this expanding fluid may enter the body’s blood circulation excessively, causing a sharp rise in blood volume, and water intoxication can be life-threatening if not treated in time. So you can’t think that hysteroscopy is a minor surgery. Q. Does hysteroscopy hurt the uterus? Is it possible to get pregnant only six months after hysteroscopy? A. Hysteroscopy or surgery is performed under direct vision. As long as the operation is standardized, the impact on the endometrium is much less than that of abortion, curettage and curettage. How long it takes to prepare for pregnancy after hysteroscopy depends on what specific operation is done. If it is a smaller operation, such as removal of polyps, tubal cannulation and lavage, you can prepare for pregnancy after the next menstrual period. In case of submucosal fibroids and operations such as uterine adhesions, the surgeon will give a specific account according to the intraoperative situation. Q. Pre- and post-operative precautions for hysteroscopy A. Pre-operative precautions: 1. Make an appointment for hysteroscopic surgery at the gynecological clinic early. The appointment is usually made near the time of menstruation. 2. Do not have intercourse after menstruation and before surgery. 3.Related tests (blood routine, coagulation function, hepatitis B, HIV, syphilis, ECG, etc.) should be completed before hysteroscopy. 4.According to the requirements before anesthesia, solid food and dairy products are prohibited for 6-8 hours, and dregs-free clear fluids are prohibited for 2-3 hours. 5.Some patients need cervical pretreatment, will be given vaginal plug misoprostol or placed cervical dilation strips the night before surgery or several hours before surgery, there may be a little vaginal bleeding, lower abdominal stuffiness, lumbar soreness, do not be nervous, if you have dizziness, nausea and panic, please contact the health care staff in time. Postoperative precautions: 1. There may be slight abdominal pain, abdominal distension and lumbar soreness after surgery, please do not worry, if the pain tends to increase, please seek medical attention in time. 2.Postoperative diet: Hysteroscopic surgery is performed in the uterine cavity without disturbing the intestinal tract, so as long as the patient is awake from anesthesia and does not feel dizzy, malignant and other symptoms, he can eat and drink normally. Please don’t worry, hysteroscopy is done with saline to expand the uterine fluid, and there will be more or less residual uterine cavity after the operation, which will be discharged from the vagina intermittently. There will be a little vaginal bleeding or bloody discharge for 1 week after surgery. During this period, it is important to keep the vulva clean and avoid intercourse, bathing, swimming and hot springs to prevent infection. If the vaginal bleeding is more than the amount of menstruation, please consult a doctor promptly. 4. If you have fever after surgery, seek medical consultation in time. 5.Not all hysteroscopic procedures require oral anti-inflammatory medication, you should consult your surgeon for details. Q: I have heard that some hysteroscopic procedures cannot be done at once and have to be done several times. A: Yes. For example, in the case of submucosal fibroids, most of the procedures can be done in one visit, but a small number of larger type II fibroids may require a second surgery. There is a possibility of water poisoning in hysteroscopic surgery, so the operation time cannot be extended indefinitely. If a patient is found to be predisposed to water intoxication during the procedure or if water intoxication has already occurred, the procedure will be stopped immediately for management. The remaining lesions will be reoperated at a later date. Then there is the possibility of staged surgery for mediastinum if the mediastinum is wide and thick. The purpose of multiple surgeries is to remove the lesions completely to ensure surgical safety and to prevent perforation of the uterus. It is also difficult to solve the hysteroscopic adhesions surgery at once. Usually, after the first hysteroscopic surgery, hormones are used to repair the endometrium and a second hysteroscopic surgery is performed 2-3 months later to assess the recovery of the uterine cavity. In conclusion, hysteroscopic staged surgery for specific diseases is based on the disease itself and on the premise that the patient’s life is safe and the uterus is protected. The specific condition and plan should be discussed with the operating surgeon, not to be biased and reject hysteroscopic surgery.