What issues can be detected through hysteroscopy?

May 08, 2025 Source: Cainiu Health

Dr. Zhang Lu

Introduction

Under normal circumstances, hysteroscopy can usually detect endometrial polyps, submucosal uterine fibroids, intrauterine adhesions, uterine malformations, blocked fallopian tube openings, and other issues. Hysteroscopy is an invasive procedure that may cause certain physical discomforts, such as vaginal bleeding and abdominal pain. Prior to undergoing hysteroscopy, patients need to adequately prepare.

Generally, hysteroscopy can usually detect endometrial polyps, submucosal uterine fibroids, intrauterine adhesions, uterine malformations, and blocked fallopian tube ostia. If discomfort occurs, timely medical consultation is recommended. Detailed analysis is as follows:

1. Endometrial Polyps

Endometrial polyps are benign neoplasms formed by abnormal proliferation of localized endometrial tissue. Under hysteroscopy, single or multiple masses of varying sizes can be observed within the uterine cavity, usually tongue-shaped or spherical, with smooth surfaces and stalks of varying thickness and length, which can attach to any part of the uterine wall.

2. Submucosal Uterine Fibroids

Submucosal uterine fibroids are a type of uterine leiomyoma that grows toward the endometrial surface, protruding into the uterine cavity and covered only by mucosa. Hysteroscopically, round or oval-shaped masses with smooth surfaces and firm texture can be observed within the uterine cavity. Sometimes the stalk connecting the fibroid to the uterine wall is visible, and larger fibroids may cause distortion of the uterine cavity.

3. Intrauterine Adhesions

Intrauterine adhesions are usually caused by prior intrauterine procedures or infections, leading to damage of the basal layer of the endometrium and resulting in partial or complete occlusion of the uterine cavity. Hysteroscopy reveals adhesions of varying severity within the uterine cavity, presenting as filmy adhesions, fibromuscular adhesions, or dense connective tissue adhesions. These adhesions may appear as bands, sheets, or webs, dividing the uterine cavity into multiple small compartments, with severe cases leading to complete obliteration of the normal uterine shape.

4. Uterine Malformations

Uterine malformations result from abnormal development of the uterus during embryogenesis. Common types include septate uterus, bicornuate uterus, and unicornuate uterus. For example, in a septate uterus, hysteroscopy reveals a longitudinal septum dividing the uterine cavity into two halves. The septum may extend from the fundus to the internal or even external cervical os, varying in thickness from thin to broad.

5. Blocked Fallopian Tube Ostia

Blocked fallopian tube ostia can affect the fallopian tubes' functions of egg pickup and embryo transport, making it one of the causes of female infertility. Under normal conditions, hysteroscopy reveals round or oval-shaped tubal ostia. When abnormalities exist, the ostia may be covered by membranous tissue, appear narrowed or even completely occluded, or be located in an abnormal position.

Hysteroscopy is an invasive procedure that may cause certain physical trauma, such as vaginal bleeding and abdominal pain. Therefore, prior to undergoing hysteroscopy, patients need adequate evaluation and preparation, and should proceed under the guidance of a physician.

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Is the hysteroscopy procedure painful?

In general, the level of discomfort during a hysteroscopy varies among individuals. Most people can tolerate the procedure, while a few may experience significant discomfort. If you are concerned about pain, it is recommended to communicate fully with your doctor beforehand and choose an appropriate pain relief method. Additionally, staying relaxed and cooperating with the procedure can further reduce discomfort. Mild abdominal pain or slight bleeding after the examination is usually normal.

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Is hysteroscopy harmful to the body?

In general, whether hysteroscopy causes harm to the body depends on the specific circumstances. If the procedure is performed strictly according to the operational guidelines and post-procedure care is followed as directed by a physician, there is generally no harm. However, if the procedure is performed improperly or post-operative care instructions are not followed, it may cause harm to the body.

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What are the symptoms of fallopian tube inflammation?

Salpingitis may be caused by unhygienic sexual practices, pathogen infection, inflammation spreading from adjacent organs, or other similar reasons. Symptoms of salpingitis include lower abdominal pain, abnormal vaginal discharge, menstrual irregularities, fever, and infertility. If related symptoms occur, it is recommended to seek timely medical attention at a hospital for a definitive diagnosis through methods such as hysterosalpingography (X-ray imaging), hysteroscopy, or laparoscopy.

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Is anesthesia required for hysteroscopy?

Whether anesthesia is required for hysteroscopy mainly depends on the type of examination. Painful hysteroscopy is usually performed without anesthesia and is suitable for patients with good pain tolerance. In contrast, painless hysteroscopy requires anesthesia, which can be administered in various ways, including local medication and injection. This approach is suitable for patients with low pain tolerance.