Hysteroscopy

A hysteroscopy is a technique used to look inside the uterus to diagnose or treat a problem. A thin, lighted telescope-like device called a hysteroscope is inserted from your vagina through your cervix and into your uterus. The hysteroscope transmits the image of your uterus onto a screen, allowing the doctor to see the inside of the uterus during the procedure. It is usually one of several instruments used during treatment.

Hysteroscopy can be done in a doctor’s office or at the hospital when you are not having your period. To make the procedure easier, your doctor may dilate your cervix with medication or special dilators before your hysteroscopy. Your doctor may also give you medication to help you relax, a local anesthetic or general anesthesia.

Hysteroscopy

A speculum is first inserted into the vagina. The hysteroscope is then inserted and gently moved through the cervix into your uterus. Carbon dioxide gas or saline (salt water) will be put through the hysteroscope into your uterus to expand it. The gas or fluid helps your doctor see the lining more clearly. The amount of fluid used is carefully checked throughout the procedure. Your doctor can see the lining of your uterus and the openings of the fallopian tubes by looking through the hysteroscope. If a biopsy or other procedure is done, your doctor may use such tools as small scissors, a wire loop or graspers to treat your specific condition, remove a polyp, resection a septum or remove an IUD.

You should be able to go home shortly after the procedure and resume your normal activities the next day. If you were given general anesthesia, you will need to wait until its effects have worn off.

It is normal to have some mild cramping or bloody discharge for a few days after the procedure. Your doctor may give you a medication to help ease the pain. If you have a fever, chills or heavy bleeding, call your doctor’s office right away. If there are no complications, you may resume sex and tampon use once bleeding stops, or in two weeks, whichever occurs first.

Risks

Hysteroscopy is a very safe procedure, but there are some small risks. The hysteroscope can puncture the uterus or cervix, bleeding may occur or excess fluid may build up in your system. In very rare cases, hysteroscopy can cause excessive bleeding, which may require a more invasive procedure or a blood transfusion.  If a problem occurs during the procedure, it will be treated.

Alternative Procedures

  • Hormonal therapies to control bleeding
  • A more invasive “open” procedure
  • Hysterectomy
  • Endometrial ablation
  • Uterine artery embolization

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