A hysteroscopic adhesiolysis is a minimally invasive procedure used to treat adhesions (scar tissue) inside the cavity of the uterus. The adhesions are removed without making a cut on the skin of the abdomen. It is done as a day case, so you can go home on the same day.
Before the surgery, some tests will be done to check your blood level, heart and kidney functions, and blood group. If an abnormality is detected or if you have been known to have a previous illness, you might need to be seen by another doctor to be cleared for surgery. If your blood level is low, you will be placed some tablets or injections to raise the blood level, or to prevent you from having another period, so that your blood level doesn’t drop. Once everything is satisfactory, a date can be fixed. This procedure is done within the first two weeks of your cycle, after the bleeding has stopped.
Hysteroscopic adhesiolysis surgery can either be done with you being asleep (general anaesthesia), or being numbed from the waist down (spinal anaesthesia), as long as there are no other medical contraindications involved.
A fluid is passed into the cavity of the uterus, to enable insertion of a thin camera which has some cutting instruments attached to it. The images are projected on a screen, and the surgeon removes the scar tissue under direct visualization. The surgery lasts for about 30 minutes. After the procedure, there is usually a need to insert something into the uterus (either a Copper IUCD or a uterine balloon) to prevent scar tissue from reforming inside the uterus. This will be removed at a clinic visit, a few weeks after the surgery.
Two to three hours after the procedure, you will be able to go home. Most people are able to go back to their regular activities by the next day; recovery takes a maximum of about one week.
If you intend to get pregnant, you will be asked to wait for about three months before you start trying again, in order to enable the uterus heal completely. In some cases of severe adhesions, there is a need to repeat the procedure two or three times.