Assoc. Prof. Dr. Pınar Kadiroğulları
Assoc. Prof. Dr. Pınar Kadiroğulları is a specialist in obstetrics and gynecology. She specializes particularly in HPV treatment and cervical cancer prevention, providing holistic healthcare to her patients in the areas of pregnancy monitoring, genital aesthetics, and gynecological surgery.
By combining her academic background with clinical experience, she offers every patient an evidence-based, personalized treatment approach.
Hysteroscopy is a modern gynecological method in which the inside of the uterus is examined in detail through the cervix using a thin telescopic camera (hysteroscope). It is used for both diagnostic (abnormal bleeding, infertility evaluation) and therapeutic purposes (removal of polyps and submucosal fibroids). Since it does not require any abdominal incision, it is now considered the gold standard in intrauterine surgery.
In modern gynecological surgical practice, the hysteroscopic approach is preferred in line with the guidelines of the AAGL and ESGE, taking into account the patient’s clinical condition and the need for diagnosis or treatment. With her expertise in advanced hysteroscopic surgery at her clinic in Nişantaşı, Istanbul, Assoc. Prof. Dr. Pınar Kadiroğulları offers her patients safe and effective solutions in either an office setting or under general anesthesia.
Information Note
Hysteroscopy is an incision-free surgical method. Diagnostic hysteroscopy takes 15-20 minutes, and patients are typically discharged the same day. For specific treatments, you can also visit our Myomectomy and Laparoscopic Surgery pages.
What Is Hysteroscopy and How Is It Performed?
Hysteroscopy is a minimally invasive gynecological method in which the inside of the uterus (uterine cavity) is visualized through a thin and flexible camera inserted through the cervix (cervical canal). Since it does not require any abdominal incision, it is also referred to as “incision-free surgery.”
Two Types of Hysteroscopy
1. Diagnostic Hysteroscopy: A procedure in which the inside of the uterus is only visualized. It can be performed in an office setting without anesthesia in 5-15 minutes, using a thin hysteroscope (3-5 mm).
2. Operative (Therapeutic) Hysteroscopy: A procedure in which abnormalities within the uterus (polyps, fibroids, septum, adhesions) are removed along with visualization. It takes 30-60 minutes under general or spinal anesthesia.
The Surgical Process
- Preparation: The procedure is scheduled within 5-10 days after the menstrual period ends (when the uterine lining is thin).
- Positioning: The patient lies in the standard gynecological examination position.
- Distension: The uterine cavity is filled with saline solution or CO2 gas to create a clear field of view.
- Visualization: The hysteroscope is inserted, and a detailed examination is performed via the monitor.
- Procedure: If necessary, treatment is carried out using specialized instruments.
Important Information
Hysteroscopy is also referred to as “closed surgery” — because no incision is made on the body to access the uterine cavity. Access is achieved through the cervix via the natural pathway, which minimizes the recovery time.
In Which Cases Is Hysteroscopy Used?
Hysteroscopy is successfully used in modern gynecology for the diagnosis and treatment of many intrauterine conditions. The indications are grouped into two main categories: diagnostic and therapeutic.
1. Diagnostic Hysteroscopy
- Abnormal uterine bleeding (heavy, prolonged, or intermenstrual bleeding)
- Postmenopausal bleeding
- Infertility evaluation: Structural assessment of the uterine cavity. For details, you can visit our Infertility Treatment page.
- Recurrent pregnancy loss
- Diagnosis of Asherman syndrome (intrauterine adhesions)
- Congenital uterine anomalies (uterine septum, didelphys)
- Evaluation of suspicious intrauterine findings detected on ultrasound
2. Therapeutic Hysteroscopy
- Removal of endometrial polyps (polypectomy)
- Removal of submucosal fibroids. For details, you can visit our Myomectomy page.
- Release of intrauterine adhesions (adhesiolysis)
- Resection of a uterine septum (septum resection)
- Removal of retained intrauterine tissue (after miscarriage)
- Endometrial ablation (treatment of heavy bleeding)
- Removal of intrauterine foreign bodies (embedded IUD)
3. Pre-IVF Evaluation: Assessment of the uterine cavity and, when necessary, the removal of polyps or fibroids, significantly improves IVF success rates.
Gold Standard
Hysteroscopy is currently the gold-standard method for diagnosing intrauterine pathologies. Suspicious or undetected intrauterine conditions that cannot be identified with ultrasound are evaluated through direct visualization with hysteroscopy and, when necessary, treated in the same session.
Advantages of Hysteroscopy
Hysteroscopy offers numerous advantages compared to open and laparoscopic methods. The fact that no incision is made on the body, along with rapid recovery and low complication rates, has made this method one of the most preferred options in modern intrauterine surgery.
1. Incision-Free Surgery
Leaves No Marks on the Body
Since access is gained through the natural pathway, no incision is made on the abdomen or vagina.
- No Incisions: No surgical incisions are made on the abdomen or vagina.
- No Scars: No visible surgical scars remain.
- Preserves Fertility: Since the uterine wall is not affected, it is ideal for women planning pregnancy.
2. Fast Recovery
Same-Day Discharge, Quick Return
Patients are typically discharged the same day and return to normal life within 1-2 days.
- Same-Day Discharge: Patients can return home after 2-4 hours of post-procedure rest.
- Quick Activity: Return to normal life the next day.
- Minimal Pain: Generally manageable with mild painkillers.
- Return to Work: Office work can typically be resumed within 2-3 days.
3. Technical Superiority
Diagnosis and Treatment in a Single Session
Hysteroscopy is the only method that offers both diagnosis and treatment in a single session.
- Treatment Under Direct Vision: Abnormalities are precisely removed under direct visual guidance.
- Low Complication Rate: The complication rate is below 0.5%.
- Tissue Sampling: Biopsies can be taken from suspicious areas.
- Improved IVF Success: When performed before IVF, it increases the chance of pregnancy.
Recovery and General Risks After Hysteroscopy
The recovery process after hysteroscopy is incomparably shorter than that of other surgical methods. Patients are typically discharged on the same day and return to their normal lives within 1-2 days. The minimally invasive nature of the method also keeps complication rates to a minimum.
Typical Recovery Timeline
- First 2-4 hours: Hospital observation and fluid intake.
- Same day: Discharge and rest at home.
- Next day: Return to normal activities.
- 2-3 days: Return to work and office tasks.
- 1 week: Sexual intercourse may be resumed after the doctor’s approval.
Temporary Symptoms That May Occur
- Mild vaginal bleeding: May last 3-7 days, considered normal.
- Mild cramping pain (1-2 days)
- Nausea (anesthesia-related, short-lived)
- Shoulder pain: 1-2 days if CO2 was used
Possible General Risks
- Uterine perforation — rare, 0.1-1%
- Anesthesia-related complications (in operative hysteroscopy)
- Fluid overload syndrome — in long procedures
- Infection (less than 0.5%)
- Cervical injury (damage to the cervix — rare)
⚠️ When to Consult a Physician
- Fever above 38°C or chills
- Excessive or clotted vaginal bleeding
- Severe and persistent abdominal pain
- Foul-smelling vaginal discharge (a sign of infection)
- Fainting, dizziness, or general weakness
Important Reminder
In experienced hands, hysteroscopy is an extremely safe surgical method. The overall complication rate is below 1%. The vast majority of patients recover without complications and quickly return to their normal lives.
Frequently Asked Questions
Is hysteroscopy painful?
Hysteroscopy is generally painless or causes only very mild discomfort. Diagnostic hysteroscopy can be performed in an office setting without anesthesia; patients describe a mild cramping sensation. Since operative hysteroscopy (for the removal of polyps or fibroids) is performed under general or spinal anesthesia, nothing is felt during the procedure. Mild cramping pain that lasts for 1-2 days afterward can be controlled with painkillers.
When should hysteroscopy be performed?
The ideal time for hysteroscopy is 5-10 days after the menstrual period ends. During this period, the uterine lining (endometrium) is at its thinnest; this allows the uterine cavity to be clearly visualized and the procedure to be performed safely. It is not performed during menstruation or pregnancy. Apart from emergencies (heavy bleeding or suspicious findings), the appointment is scheduled according to the menstrual cycle.
How long should I wait to try for pregnancy after hysteroscopy?
The waiting period to try for pregnancy after hysteroscopy depends on the type of procedure performed. After diagnostic hysteroscopy, pregnancy can be attempted 1 month later. After the removal of polyps or small submucosal fibroids, a wait of 2-3 months is recommended, while after the treatment of Asherman syndrome or a uterine septum, 3-6 months is advised. Your doctor will determine a personalized waiting period based on the details of your procedure.
Does hysteroscopy require anesthesia?
Anesthesia requirements vary depending on the type of hysteroscopy. Diagnostic hysteroscopy can be performed in an office setting without anesthesia or with mild sedation. Operative hysteroscopy (such as the removal of polyps or fibroids, or the treatment of a uterine septum) is performed under general or spinal anesthesia. The choice of anesthesia is determined based on the duration of the procedure, the patient’s clinical condition, and personal preference.
When can I resume sexual intercourse after hysteroscopy?
Sexual intercourse should be avoided for at least 1 week after hysteroscopy. This period is necessary for the healing of the uterine lining and to minimize the risk of infection. After operative hysteroscopy (such as the removal of polyps or fibroids), this period may extend up to 2-3 weeks. Sexual intercourse should be avoided as long as vaginal bleeding continues. The exact waiting period should be determined under your doctor’s supervision.
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References
The medical content on this page has been prepared based on the current clinical guidelines and scientific publications of international and national authoritative organizations. Below, you can review the main PDF references used for hysteroscopy practice and the academic publications of Assoc. Prof. Dr. Pınar Kadiroğulları.
The Use of Hysteroscopy for the Diagnosis and Treatment of Intrauterine Pathology: ACOG/AAGL Joint Committee Opinion No. 800
Authors: American College of Obstetricians and Gynecologists (ACOG) & American Association of Gynecologic Laparoscopists (AAGL) | Publication: Obstet Gynecol 2020 | Source Type: International Clinical Committee Opinion
Office Hysteroscopy: RCOG Green-top Guideline No. 59 (Latest Edition)
Authors: Royal College of Obstetricians and Gynaecologists (RCOG) & British Society for Gynaecological Endoscopy (BSGE) | Publication: BJOG 2024 | Source Type: Green-top Clinical Guideline, 2nd Edition
AAGL Practice Report: Management of Hysteroscopic Distending Media
Author: American Association of Gynecologic Laparoscopists (AAGL) | Publication: J Minim Invasive Gynecol 2013 | Source Type: International Clinical Practice Guideline (PubMed)
AAGL/ESGE Joint Guideline: Hysteroscopic Management of Intrauterine Adhesions (Asherman Syndrome)
Authors: American Association of Gynecologic Laparoscopists (AAGL) & European Society of Gynaecological Endoscopy (ESGE) | Publication: J Minim Invasive Gynecol 2017 | Source Type: Joint Clinical Guideline by Two Organizations (PubMed PMC, Full Text)
BSGE/ESGE Guideline on Fluid Distension Management in Operative Hysteroscopy
Authors: British Society for Gynaecological Endoscopy (BSGE) & European Society for Gynaecological Endoscopy (ESGE) | Publication: Gynecological Surgery 2016 | Source Type: Joint Guideline by Two European Organizations (PubMed PMC, Full Text)
International Consensus Terminology for Hysteroscopic Procedures
Authors: Carugno J, Grimbizis G, Franchini M, et al. | Publication: J Minim Invasive Gynecol 2022;29(3):385-91 | Source Type: International Consensus Document
Clinical Practice in Office Hysteroscopy: Patient Evaluation and Management of Complications
Publication: Obstetrics & Gynecology Science 2024 | Source Type: Peer-Reviewed Clinical Review (PubMed PMC, Full Text)
⭐ Academic Publications by Assoc. Prof. Dr. Pınar Kadiroğulları on Uterine Surgery
Publications authored by the doctor in the fields of uterine surgery, gynecological procedures, and sexual/anatomical integrity
Abdominal Hysterectomy with a Uterine Manipulator: A Randomized Controlled Clinical Trial
Authors: Kıyak H, Karacan T, Özyürek ES, Türkgeldi LS, Kadiroğulları P, Seçkin KD | Publication: Journal of Investigative Surgery 2021;34(10):1052-1058 | Source Type: Randomized Controlled Clinical Trial (PubMed)
📍 This publication directly addresses the use of a manipulator in uterine procedures, covering the principles of uterine surgery that also form the basis of hysteroscopic interventions.
Modified Extraperitoneal Uterosacral Ligament Suspension: A 4-Clamp Technique After Vaginal Hysterectomy
Authors: Kadiroğulları P, Seçkin KD | Publication: Journal of Investigative Surgery 2019 | Source Type: Peer-Reviewed Clinical Research (PubMed)
The Relationship Between HbA1c Levels and Ovarian Reserve: A Clinical Study in Type 1 Diabetes Patients
Authors: Kadiroğulları P, Demir E, Bahat PY, Kıyak H, Seçkin KD | Publication: Gynecological Endocrinology 2020;36(5):426-430 | Source Type: Peer-Reviewed Scientific Article (PubMed)
Important Note
The information on this page is intended for general informational purposes and does not replace individual medical advice. For personal questions, diagnosis, or treatment planning related to hysteroscopy, you should always consult your specialist gynecologist. The content of this page has been prepared by Assoc. Prof. Dr. Pınar Kadiroğulları in light of clinical experience and current scientific literature.
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