Hysteroscopy is a procedure that allows us to closely examine the inside of the uterus. Hysteroscopy is done without incisions and causes little discomfort. For most women, there is also little risk. It can be used to evaluate abnormal bleeding, scarring, polyps, malformations, fibroids, and infertility. It can also be used to treat certain uterine conditions. There are two different kinds of hysteroscopy: diagnostic hysteroscopy and operative hysteroscopy.

Diagnostic Hysteroscopy:

Diagnostic hysteroscopy is used to examine the inside cavity of the uterus. This procedure can assist your doctor in the diagnosis of abnormal uterine conditions such as internal fibroid tumors, scarring, polyps, and congenital malformations. Therefore, hysteroscopy is an important tool in the study of infertility of abnormal uterine bleeding.

Before performing hysteroscopy, your physician may recommend a hysterosalpingogram, an x-ray of the uterus and fallopian tubes. Also, a D&C or dilation and curettage, a scraping of the inside of the uterine cavity, may be performed after hysteroscopy.

The first step in hysterocopy involves stretching and opening the canal of the cervix with a series of dilatators. Once the dilation is complete, the hysteroscope, a narrow lighted instrument thinner than a pen similar to the laparoscope, is passed through the cervix and into the lower end of the uterus. A light source and video camera are attached to the end of the hysteroscope. The inside of the uterus can then be seen on a TV screen. A clear solution or carbon dioxide gas is then injected into the uterus through the instrument. This solution or gas expands the uterine cavity, clears blood and mucus away, and enables your surgeon to directly view the internal structure or the uterus.

Diagnostic hysteroscopy is usually conducted on an outpatient basis with either general or local anesthesia and takes about thirty minutes to perform.

Thirty minutes before the procedure, you may be asked to take 3 tablets of Advil or Motrin to lessen any cramps during the procedure. A warm heating pad on your abdomen may also be used to lessen the cramps. We may numb your cervix with local anesthesia. If the procedure is done in the hospital, you will be given regional or general anesthesia.

Complications due to diagnostic hysteroscopy are rare, occurring in less than 1% of cases. They can include problems with anesthesia, infection, excessive bleeding or perforation of the wall of the uterus.

After the procedure, you may have light bleeding and menstrual-type cramps for 1-2 days. If carbon dioxide gas is used, some gas may escape into your abdomen. This is harmless but can cause shoulder aching for 1-2 days. You will need to avoid sexual intercourse, tampons, and douching for 1-2 weeks after the procedure.

You should call us immediately if you have heavy bleeding, a fever over 101 degrees, or increasing abdominal pain.

Operative Hysteroscopy:

Operative hysteroscopy can be used to treat certain uterine problems and in some cases may help you avoid abdominal surgery or hysterectomy. Polyps and fibroids inside the uterus can be removed in this way. Patients with abnormal uterine bleeding can be treated with endometrial ablation - a procedure to destroy the inside lining of the uterus. Scar tissue can also be removed from the inside of the uterus using hysteroscopy. This can help restore fertility. Operative hysteroscopy is done in the operating room, but usually does not require an overnight stay.