Is It Safe To Have Hysteroscopy Before Planning For Pregnancy?
1.Request you to go through the attached prescription where the doctor has described the issues and done treatment and advise if the doctor is performing the correct treatment and medication.
2.Also now the doctor is asking to Hysteroscopy which is major testing and requires anesthesia.I want 2 know if the same is really needed
3.Wanted to know as we would be planning for a baby in coming 6 months to 1 year therefore all these prodeures and medications wether will effect that or these are safe
Detailed answer below
Detailed Answer:
Hi XXXXXXX I have gone through your question and understand your concerns.
I have reviewed your wife's prescription and reports.
1. Your wife Mrs XXXXXXX is having LSIL which low grade squamous intraepithelial lesion in cervix. It is a condition which can lead to cervical cancer, but in very rare case.The treatment of a LSIL lesion in cervix is colposcopy and cervical biopsy to rule out cancer, and HPV testing.HPV is negative in her case and the biopsy shows only infection which can be treated by vaginal pessaries.
Further this condition is followed up only by Pap amear & HPV testing every yearly or pap smear every 6 monthly. No other treatment or investigation is required.
2. I could not infer from your prescription any reason for doing hysteroscopy. So, in my opinion, no hysteroscopy is required.
3. Hysteroscopy can lead to intrauterine infection and adhesions, which can lead to difficulty in conception. the medications you have taken earlier will not have any effect on future pregnancy.
Hope you found the answer helpful. Please do get back for further queries.
Wishing you good health.
Regards,
Dr Deepti Verma.
Thanks for your advise
The consulting doctor has mentioned Hysteroscopy and reason on page no.5 of the prescription.
She had prescribed this maybe due to the fact that my wife told her of heavy bleeding after the first periods after the colposcopy and cryo but she never had heavy periods in the past
Also yesterday she again got bleeding though her periods had already come om 20-25 th of july
this type of scenario in bleeding was never witnessed in the past and only happened recently after the mentioned treatment taken as per the prescription.
Now we are confused that may this is happening due to madications or treatment that the doctor has prescribed but the doctor is insisting on hysteroscopy for which we are not reday
Please advise what should we do
Hysteroscopy not needed
Detailed Answer:
Hi XXXXXXX thanks for responding. It is common to have heavy bleeding after cervical biopsy. Irregular bleeding can also occur for few days after biopsy till the biopsied area completely heals.
Moreover, according to the medical guidelines, single episode of irregular or heavy bleeding do not warrant any investigation, more so never an invasive procedure like hysteroscopy. We should wait for 2-3 months to see if the complain persists, and then do hormonal investigations and endometrial biopsy,if needed. Endometrial biopsy is a simple office procedure and do not requires any anaesthesia. Hysteroscopy is the last resort done when the results are inconclusive in endometrial biopsy.
Hope you found the answer helpful. Please do get back for further queries.
Wishing you good health.
Regards,
Dr Deepti Verma.
Thanks for the very useful advise about hystroscopy .Had some more queries as below:
1.As I said earlier XXXXXXX is having bleeding again which started yesterday although the normal Oeriod cycle got over on 20-21-22 and then on 24-25-26-27-28 and now againit started from 31st july and is still on . The current doctor told her to have Khushi-contraceptive medicine to stop bleeding. is it ok to take this medicine as even after taking this since yesterday still the bleeding didnt stopped till now? or should she continue as it is without medicine till bleeding gets over on its own .Cryocautery and Colposcopy and vaccination was done on 12th July.
2.She is taking presently Oflox-400,Septilin & Energex capsiules is this medication ok and should she continue to heel the lesion and Biopsy wound and the infections that have come in reports or anything else is required
3.She is having pain in lower abdomen and on vaginal lips , is this any symptom of any diseases or problem or related with these procedures and get cured by itself.
4.Doctor have also advised her to take thyroxin as her THS was 4.12 below thw upper line but our local chemist said that it is not required as still the THS hasnt crossed the border line ,Request if you cam advise what is to be done.
5. Lastly Please check all her reports once again such as urine,CRP,THS and colposcopy and culture HPV and advise if any thing is serious there and has to be treated other than the prescribed medication or by some home remedy.
6.Request if ypu can advise some home remedies or supplements to cure the infections in reports and best way we can avoid these costly procedures and medications.
7 XXXXXXX is using sanitary naplkins due to bleeding and watering is these are safe to use or should not be used.
8. As per your advise we will not go for Hysteroscopy and if you advise we can change the doctor also.
I know my queries are too many but would be very grateful if you can advise and support me on this as we have to s[pend every rupee carefully and take care of our loved ones to the fullest.
Thankingyou in advance
Detailed answer below
Detailed Answer:
Hi XXXXXXX I can understand the difficulties you both are facing. I will try to help you completely and answer your queries as you asked.
1. There is no need to take Khushi contraceptive to stop bleeding as it is not usually the first line management for irregular bleeding. Rather, she should take Primulet N 5 mg twice a day for 5 days followed by 5 mg once a day for next 16 days to regularize the periods.
2. Oflox-400 is ok, but septilin and energex tablets are not needed at all. They have no role in her treatment.
3. The pain she is having is due to the vaginal procedures and cervical biopsy she had. It will resolve with time.
4. When TSH level is more than 2.5, then a test called Anti TPO antibodies is done, if it is positive then thyroid supplementation is started, otherwise there is no need.
5. CRP is high, but requires no treatment. Rest TSH is normal, HPV is negative. Colposcopy shows positive finding, but no urgent treatment is required. She should get her Pap smear done every 6 monthly.
6. Oflox -400 is given for cervical infection. Other costly medications not required.However,She should get her Pap smear done every 6 monthly.
7. Sanitary napkins are safe.
8. You can very well change the doctor as , in my opinion, you both are being burdened with unneccessary investigations, costly procedure and medications.
I am always there to help you. You can ask me any query directly by posting a direct question in my profile on this portal.
Hope you found the answer helpful. Please do get back for further queries.
Wishing you both good health.
Regards,
Dr Deepti Verma
Thanks for the valuable advise
Wanted to clarify some more doubts like
1.Colposcopy & Cryotherapy was done on 12th of July but last 3 days XXXXXXX is again observing white substense in her vagina but without a discharge along with itching and pain.
2. she is also feeling Urine pressure frequently but not actually want to Urinate but just a feeling like before.
3.Just a Backround along with the above history she also had urine problems in the past 6 months to 1 year where she had to go for urination quite frequently and some times the problem became chronic and cured only after taking PIREDIUM for 5 day course.
4.Are all these symptons are common and will subside with time or something else is to be done.
5.I am attaching some doctor prescriptions and test reports of urine culture and routine and pap smear done in past
6.Now I want to know what should be the complete line of treatment for all this and how to proceed further
4.
Detailed answer below
Detailed Answer:
Hi XXXX, I will answer your questions as you asked;
1. White substance in vagina along with itching and pain is most likely due to vaginal infection. She needs to get a vaginal swab examination to find out the type of infection and get treatment accordingly.
2. Urine pressure quite frequently could be due to urinary tract infection.
3. If there is recurrent urinary tract infection, then proper urine examination and ultrasound is required, to rule out the cause of recurrent urinary tract infection. Intake of pyridium repeatedly without the proper urine examination is not recommended.
4.No, these symptoms are not common and need proper evaluation.
5. I have reviewed the reports , but there was no report attached of LBC or pap smear.
Your doctor has given a lot of antibiotics without any confirmed indication. Such extensive antibiotic use is not needed without any indication.
Moreover, there is no vaginal swab examination done despite your wife repeatedly complained of vaginal discharge.
6. She should get a vaginal swab examination, urine culture and sensitivity examination and a renal ultrasound to confirm the diagnosis and further management should be done accordingly.
I am always there to help you. You can ask me any query directly by posting a direct question in my profile on this portal.
Hope you found the answer helpful. Please do get back for further queries.
Wishing you both good health.
Regards,
Dr Deepti Verma
Answered by
Dr. Deepti Verma
OBGYN, Maternal and Fetal Medicine
Practicing since :2009
Answered : 5064 Questions