Hysteroscopic Surgery

Hysteroscopic Surgery in Turkey: Minimally Invasive Treatment for Uterine Conditions

In the field of gynecological surgery, Hysteroscopy represents the peak of minimally invasive technology. Unlike laparoscopy, which views the organs from the inside of the abdomen, hysteroscopy focuses exclusively on the inside of the uterus (uterine cavity). It is globally recognized as the Gold Standard for both diagnosing (Diagnostic) and treating (Operative) numerous conditions that cause infertility, recurrent miscarriages, and abnormal bleeding.

At Dr. Cengiz Andan’s Clinic in Istanbul, Turkey, we perform hysteroscopic procedures without any external cuts or incisions. A slender telescope (Hysteroscope) equipped with a light and camera, only a few millimeters wide, is gently passed through the vagina and cervix into the uterine cavity. The cavity is then expanded with fluid to provide a crystal-clear, magnified view on a monitor.

This technique allows us to detect and treat intrauterine issues—such as polyps, small fibroids, or a uterine septum—problems that are often missed or only suspected by standard ultrasound. All treatment can be completed in the same session.

1. Types of Hysteroscopy: Diagnostic vs. Surgical

Hysteroscopy is divided into two primary types based on its purpose and the instruments used:

A. Office Hysteroscopy (Diagnostic Hysteroscopy)

This is a quick procedure, often performed with minimal or no anesthesia, directly in the examination room.

• Purpose: To investigate the underlying causes of infertility, recurrent pregnancy loss, or abnormal uterine bleeding by visually inspecting the entire uterine cavity.
• Process: Extremely thin instruments (3-5 mm) are used. Patients typically experience very little to no pain and can often watch the procedure on the screen. Recovery is immediate.

B. Operative Hysteroscopy (Surgical Hysteroscopy)

This procedure is performed to surgically treat a diagnosed intrauterine problem (polyp, fibroid, septum, etc.) and usually requires general anesthesia for patient comfort and precision.

• Purpose: To surgically remove, cut, or correct pathology inside the uterus to restore a healthy environment for embryo implantation or to stop abnormal bleeding.
• Process: Specialized surgical micro-instruments (scissors, electrodes, morcellators) are passed through the hysteroscope to perform the surgery. No external stitches are needed.

2. Conditions Treated by Hysteroscopic Surgery in Istanbul

Hysteroscopy is the definitive solution for almost all mechanical issues that affect the integrity and function of the uterine cavity. The most common procedures performed by Dr. Cengiz Andan include:

3. Hysteroscopy and IVF Success: Preparing the Uterus

For patients experiencing recurrent IVF failure, evaluating the uterine cavity with hysteroscopy is often critical. A microscopic polyp, a mild adhesion, or chronic inflammation (endometritis) at the site of potential embryo implantation can be the silent cause of failed cycles.

Dr. Cengiz Andan often recommends hysteroscopic evaluation before embarking on a new IVF cycle, particularly after previous failed attempts. Studies suggest that the procedure itself, or a controlled injury technique known as “endometrial scratching” performed during the hysteroscopy, may improve subsequent pregnancy rates by triggering a localized healing and immune response that aids implantation.

Frequently Asked Questions (FAQ) for Patients Traveling for Hysteroscopy

• Is hysteroscopy a painful procedure? Diagnostic (office) hysteroscopy is generally painless, often feeling only like mild menstrual cramping. Operative (surgical) hysteroscopy is performed under anesthesia, ensuring you feel nothing during the procedure. Post-operatively, you may experience mild cramping for 1-2 days, which is easily managed with oral painkillers.
• How soon can I attempt to get pregnant after the procedure? For simple procedures like polyp removal, you can often try to conceive after your very next menstrual period. For more complex surgeries, such as uterine septum resection, we typically recommend a waiting period of 1-2 months coupled with temporary estrogen therapy to ensure the uterine lining heals perfectly, optimizing it for pregnancy.
• What is the difference between D&C (Dilation and Curettage) and Hysteroscopy? D&C is considered a “blind” procedure, where the doctor scrapes the uterine lining without visual guidance. Hysteroscopy is a “visual”procedure. We can see exactly where the problem is and treat only that localized area, meticulously protecting the surrounding healthy uterine tissue. For fertility preservation and precise removal of pathology, hysteroscopy is vastly superior to D&C.
• Do I need to stay overnight in the hospital? No. Hysteroscopy is almost always performed as a day-case procedure. You arrive in the morning, undergo the procedure, rest for a few hours in recovery, and are discharged home the same day. Most patients are fit to return to work or light activities the next day.

Dr. Cengiz Andan utilizes advanced hysteroscopic techniques to resolve uterine conditions with unmatched precision,aiming to clear the path for your future pregnancy and restore your quality of life.