Hysteroscopy is a procedure that allows your doctor to look inside your uterus in order to diagnose and treat causes of abnormal bleeding (heavy or lengthy menstrual flow, less often or more often than usual). Hysteroscopy is done using a hysteroscope, a thin, lighted tube that is inserted into the vagina to examine the cervix and inside of the uterus. Additionally, hysteroscopy can be used with other procedures, such as laparoscopy, or before procedures such as dilation and curettage (D&C).
Hysteroscopy can be either diagnostic or operative. Diagnostic hysteroscopy is used to diagnose problems of the uterus. Diagnostic hysteroscopy is also used to confirm results of other tests, such as hysterosalpingography (HSG).
Your doctor may perform hysteroscopy to correct the following uterine conditions:
Polyps and fibroids. Hysteroscopy is used to remove these non-cancerous growths found in the uterus.
Adhesions. Also known as Asherman’s Syndrome, uterine adhesions are bands of scar tissue that can form in the uterus and may lead to changes in menstrual flow as well as infertility. Hysteroscopy can help your doctor locate and remove the adhesions.
Septums. Hysteroscopy can help determine whether you have a uterine septum, a malformation of the uterus that is present from birth.
Abnormal bleeding. Hysteroscopy can help identify the cause of heavy or lengthy menstrual flow, as well as bleeding between periods or after menopause. Endometrial ablation is one procedure in which the hysteroscope, along with other instruments, is used to destroy the uterine lining in order to treat some causes of heavy bleeding.
Your doctor may recommend scheduling the hysteroscopy for the first week after your menstrual period. This timing will provide the doctor with the best view of the inside of your uterus. Prior to the procedure, your doctor may prescribe a sedative to help you relax. You will then be prepared for anesthesia. The type of anesthesia used is determined by where the hysteroscopy is to be performed (hospital or doctor’s office) and whether other procedures will be done at the same time. If you are having general anesthesia, you will be told not to eat or drink for a certain amount of time before the hysteroscopy.
The doctor will dilate (widen) your cervix to allow the hysteroscope to be inserted. A speculum is first inserted into the vagina. The hysteroscope is then inserted and gently moved through the cervix into your uterus. A fluid, such as saline (salt water) or dense sugar solution will be put through the hysteroscope into your uterus to expand it. The fluid helps your health care provider see the lining more clearly. The amount of fluid used is carefully checked throughout the procedure. Your health care provider can view 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, small instruments will be passed through the hysteroscope.
If regional or general anesthesia is used during your procedure, you may have to be observed for several hours before going home. After the procedure, you may have some cramping or slight vaginal bleeding for one to two days. It is also not unusual to feel somewhat faint or sick. However, if you experience any of the following symptoms, be sure to contact your doctor:
Severe abdominal pain
Heavy vaginal bleeding or discharge
Hysteroscopy is considered minor and safe surgery and usually does not require an overnight stay in the hospital.