Hysteroscopy

What is Hysteroscopy?

Hysteroscopy is a technique used to look inside the uterus. A hysteroscope, a thin, telescope-like device, is inserted into the uterus through the vagina and cervix. The hysteroscope transmits the image of your uterus onto a screen, allowing the healthcare provider to see inside the uterus.

Why is it done?

One of the most common uses for hysteroscopy is to find the cause of abnormal uterine bleeding. Abnormal bleeding can mean that a woman’s periods are heavier or longer than usual, occur less or more frequently, or involve bleeding between periods.

In some cases, abnormal bleeding may be caused by benign (non-cancerous) growths in the uterus, such as polyps or fibroids. Hysteroscopy allows your healthcare provider to look for polyps or fibroids. If found, a special instrument passed through the hysteroscope can be used to remove them. If no growths are found, a tissue sample can be obtained for biopsy. If the tissue sample does not reveal cancer but the bleeding persists, a hysteroscope with a heated instrument can stop the bleeding by destroying the lining of the uterus.

Hysteroscopy may also be used in the following situations:

• Remove adhesions that may occur from infection or past surgery
• Diagnose the cause of repeated miscarriage (when a woman has more than two miscarriages in a row)
• Locate an intrauterine device (IUD)
• Perform sterilization, where the hysteroscope is used to place small implants in the fallopian tubes as a permanent form of birth control.

You should not have a hysteroscopy if you are pregnant, have a vaginal or urinary tract infection, or have known cancer of the uterus.

What to expect

Hysteroscopy can be done in a healthcare provider’s office or at the hospital, and it is scheduled when you are not having a menstrual period. To make the procedure easier, your cervix may be dilated before your hysteroscopy. You may be given medication that is inserted into the cervix or special dilators may be used.

Before the procedure, you may be given medication to help you relax, or a general or local anesthetic may be used to block the pain. If you have general anesthesia, you will not be awake during the procedure.

A speculum is first inserted into the vagina. Then, the hysteroscope is inserted and gently moved through the cervix into your uterus. Carbon dioxide gas or a fluid, such as saline, will be put through the hysteroscope to expand your uterus. This allows your healthcare provider to see the lining more clearly. The amount of fluid used is carefully checked throughout the procedure. By looking through the hysteroscope, your healthcare provider can see the lining of your uterus and the openings of the fallopian tubes. If a biopsy or other procedure is done, your healthcare provider will use small tools passed through the hysteroscope, such as small scissors or a wire loop.

Your Recovery

You should be able to go home shortly after the procedure. If you were given general anesthesia, you may need to wait until its effects have worn off. It is normal to have some mild cramping or a little bloody discharge for a few days after the procedure. You may be given medication to help ease the pain. If you experience a fever, chills, or heavy bleeding, call your healthcare provider’s office right away. Talk to your healthcare provider about when you can get back to your normal activities. For most women, it is the next day. You may be given some instructions about when you can resume sex or use tampons.

Risks

Hysteroscopy is a very safe procedure. However, there is a small risk of problems. The uterus or cervix can be punctured by the hysteroscope, bleeding may occur, or there may be excess fluid build-up in your system. In very rare cases, hysteroscopy can cause life-threatening problems. If a problem occurs during the procedure, it will be treated. Make sure to talk with your healthcare provider if you have questions about the risks of hysteroscopy.