You can undergo the office hysteroscopy through technological innovation that has enabled in recent years to create a new generation of small hysteroscopic instruments, with diameters ranging between 2.9 and 5 mm, based on complex systems of lenses or fibers optics. With these instruments, it is now possible to perform surgeries in outpatient diagnostic phase (i.e., multiple biopsies, polypectomies) and, more importantly, without the need for any sedation or anesthesia.

The office hysteroscopy is performed by introducing the hysteroscope directly into the vagina without the use of instruments such as the speculum or cervical grasping forceps that are frequent causes of pain and complications (i.e. vagal reflex). The vaginoscopic approach therefore is used to reduce the painful symptoms associated with the use of certain instrumentation. The vagina is stretched using sterile saline water. The hysteroscope highlights the ectocervix and supports the instrument tip on the channel beginning the diagnostic and operative hysteroscopy phase.

Among the advantages of the office hysteroscopy, the main one is that allowing to perform at the same time the diagnosis and, in many cases, the surgical phase, in a state of sedation or not. And this in a single session and in Day Surgery or as outpatient.

Among the advantages of the office hysteroscopy, the main one is that allowing to perform at the same time the diagnosis and, in many cases, the surgical phase, in a state of sedation or not. And this in a single session and in Day Surgery or as outpatient.

In many cases, the discomfort during the examination is similar to that experienced during menstruation. Frequently it's chosen an examination with the use of local anesthetics, however this can be suspended at any time. In very rare cases (4%), it is used the general anesthesia.

The examination results are immediate and the report is given to the patient during the same examination. If a sampling of endometrial material is made of if polyps or myomas are removed, the histology examination report is delivered to the patient after about 10 working days (on a scheduled date, notified to the patient).

In the gynecologic surgical field, the curettage is an obsolete technique and is only used in rare and very specific cases. This is because it is a "blind" technique performed, administering general anesthetics and then it is characterized by a hospital stay. Through the office hysteroscopy, followed by the outpatient and without major disruption, it is possible to evaluate, for example, what are the causes of bleeding, or to analyze polyps, fibroids and very small lesions (hyperplasia), which over time could become cancer possibly by performing a biopsy on them for histological confirmation.

The performance of the examination can be difficult, but not impossible, in the presence of stenosis of the cervical canal, marked back or directed flexion or prolapsed uterus.

Hysteroscopy is not performed:

• During menstruation (for difficulties of vision, interpretation and dissemination of endometrium through the fallopian tubes)
• During pregnancy
• In the presence of cervico-vaginal infections (P.I.D. - to avoid the risk of dissemination and exacerbation of infection, and/or failure of a PID)
• In the presence of severe heart disease

The bleeding of the uterus prevents a correct view and thus prevents an adequate analysis of the cavity to intercept the presence of any diseases. For this reason, although the examination does not present a contraindication, it is good it is finished before its execution.

The day on which you must carry out the examination, it is best you stay on an empty stomach or you prefer a light meal. You must have performed an electrocardiogram by not more than 6 months; tell your doctor if you have a prolapse of the mitral valve (for a possible antibiotic prophylaxis) and if you have allergies to medicines or other details. To prevent any contamination during the examination and subsequent infection of the uterine cavity, the patient needs to take vaginal disinfectant ovules (Chemicetina or Keimicina) a few days before the examination.

After the examination, the patient may have minor bleeding (blood spotting) for 48/72 hours, which is why it is preferable to avoid sexual intercourse.
She instead must tell the doctor the presence of:

• Heavy bleeding in the days following the examination
• Fever and/or pain
• White, malodorous vaginal discharge