Hysteroscopy: What Women Need t... Video Transcri...

Participants

Linda Bradley MD, Steve Cohen MD, Martin S. Goldstein MD, Keith Isaacson MD, Grace Janik MD, Dean S. Cunningham MD

Summary

For many doctors, hysteroscopy represents a great leap forward in gynecology. Others have been slower to embrace this new technology. What should patients know in order to navigate this uncertain terrain? Join us as we talk to four of the nation's leading experts to find out.

Webcast Transcript

MARY WAGNER: Welcome to our webcast. I'm Mary Wagner. Today we have four of the leading gynecologists and experts on hysteroscopy and abnormal uterine bleeding.

Dr. Linda Bradley, Director of Hysteroscopic Services at the Cleveland Clinic; Dr. Steven Cohen, Director of the Center for Women's Minimal Access Surgery at Columbia University; Dr. Keith Isaacson, Director of Reproductive Endocrinology and Infertility at Massachusetts General Hospital and Harvard Medical School, and Dr. Grace Janik, Associate Clinical Professor at the Medical College of Wisconsin and Director of Reproductive Endocrinology at St. Mary's Hospital in Milwaukee.

So what are some of the questions that patients need to ask about hysteroscopy?

KEITH ISAACSON, MD: Well, first of all, patients need to again be aware that hysteroscopy is a valuable tool for making the diagnosis of the cause of their abnormal uterine bleeding. And then patients should understand the procedure itself. When they come into the examination room, the more information they have ahead of time, the less anxiety that will be produced. So they should understand the procedure. They're going to get on a routine exam table. They're going to have a speculum exam. There will be a rigid or semi-rigid scope placed through the cervix, but this should cause minimal cramping. The uterine cavity needs to be distended with some fluid, usually just some saline or salt water. Very little has to be used to visualize the cavity and the whole procedure will take somewhere between two and five minutes and they can go about their daily activities after that.

I think once they understand the whole procedure is fairly benign. It's not too uncomfortable, then they're going to be more anxious to ask for it when they approach their health care provider.

STEVEN COHEN, MD: We're in a state of transition now. There are some gynecologists who are doing hysteroscopy in the office. There are some doing it in the operating room and then there are some not doing it at all. So the patient may or may not even get offered hysteroscopy. And somewhere along the line and I think the purpose of these types of webcasts are to tell patients that this is available. So they may say to the doctor, even if the doctor doesn't bring it up, what about a hysteroscopy? What about helping me -- would that help me in the diagnosis of what my problem is? Especially, if they've had a D & C or other procedures done. So they may bring it up and that might open up a conversation with their physician and the physician may either bring it up or say, "Well, I don't do hysteroscopy, but I'll refer you to somebody who is expert in that." So I think it's nice to educate the patients out there so that they know that these procedures are now available in this modern era.

LINDA BRADLEY, MD: I had a patient just last week who thought for many, many years it was normal to use 50 pads a day for a menstrual cycle. She actually went so far as to make plastic covers for her chairs at home. She had a seat that she sat in when she was on her menstrual cycles. Her whole life revolved around knowing when her period occurred. She wouldn't make a vacation or travel plans or be able to attend her kid's soccer game because she was always incessantly changing her pads.

So I think knowing what's normal, what's abnormal and getting an evaluation when a problem persists and knowing that there is absolutely something else that can be done to help in the evaluation for your problem.