Hysteroscopy

  • Definition

    This procedure uses a hysteroscope to view the inside of a woman’s uterus (womb). A hysteroscope is a long, thin telescope with a camera on the end. Other small, surgical tools may also be inserted into the uterus through the hysteroscope.
    Female Reproductive Organs
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  • Reasons for Procedure

    Hysteroscopy is done for:
    • Diagnostic reasons—to examine the inner uterus to identify problems or abnormalities; may be done if you have:
    • Therapeutic reasons—to correct anatomic problems and defects in the uterus; may be done for:
      • Endometrial ablation—removal of uterine lining from the uterus
      • Myomectomy—removal of fibrous or muscular tissue (fibroids)
      • Removal of polyps (usually noncancerous)
      • Removal of intrauterine devices (IUDs)
    The result of the hysteroscopy depends on the reason for the procedure. In some cases, the doctor may be able to treat a condition right away. In other cases, you may need further surgery or other treatment.
  • Possible Complications

    Complications are rare. But, no procedure is completely free of risk. If you are planning to have hysteroscopy, your doctor will review a list of possible complications. These may include:
    • Swelling or bleeding
    • Infection
    • Organ injury
    • Reaction to anesthesia
    Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:
    • Smoking
    • Drinking
    • Chronic disease such as diabetes or obesity
    The following may also increase the risk of complications:
  • What to Expect

    Prior to Procedure
    Your doctor will ask about your medical history, medicines, and allergies. A physical exam will be done. Blood tests may also be done.
    Leading up to the procedure:
    • Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
      • Anti-inflammatory drugs (such as aspirin)
      • Blood thinners (such as clopidogrel or warfarin)
    • Arrange to have someone drive you home. Also, arrange for help at home.
    • If instructed, eat a light meal the night before the surgery. Do not eat or drink anything after midnight.
    Anesthesia
    Depending on the reason for the hysteroscopy, your doctor may use:
    • General anesthesia—blocks pain and keeps you asleep through the surgery; used for therapeutic procedure
    • Regional anesthesia—numbs one area of the body; used for diagnostic or therapeutic procedure
    • Local anesthesia—just the area that is being operated on is numbed; given as an injection and may also be given with a sedative; used for diagnostic procedure
    Description of the Procedure
    A device called a speculum will be inserted into the vagina. It will hold your vagina open and allow instruments to enter easily. The doctor will clean the vagina and may dilate the cervix. The hysteroscope will then be put into the uterus through the vagina and dilated cervix. The uterus will be filled with carbon dioxide gas or a liquid. This will cause the uterus to inflate, allowing the doctor to get a closer, clear look at the uterine walls.
    If you are having the procedure done for diagnostic reasons, the doctor will examine the uterus for abnormal tissue. A biopsy may be taken. Or, the uterine walls may be swabbed to get cell samples.
    If you are having the procedure done for therapeutic reasons, the doctor may insert small surgical tools through the hysteroscope. The doctor will use the tools to remove diseased tissue and make repairs. In some cases, the doctor will use another viewing tube called a laparoscope. It will be passed into the abdomen. This allows the doctor to monitor the outside of the uterus and detect any possible perforation of the uterus by the hysteroscope.
    How Long Will It Take?
    About 15-45 minutes (or longer for therapeutic procedure)
    How Much Will It Hurt?
    You will have mild cramping and soreness. Ask your doctor about pain medicine.
    Post-procedure Care
    During your stay, the hospital staff will take steps to reduce your chance of infection such as:
    • Washing their hands
    • Wearing gloves or masks
    • Keeping your incisions covered
    There are also steps you can take to reduce your chances of infection such as:
    • Washing your hands often and reminding visitors and healthcare providers to do the same
    • Reminding your healthcare providers to wear gloves or masks
    • Not allowing others to touch your incisions
  • Call Your Doctor

    After arriving home, contact your doctor if any of the following occurs:
    • Signs of infection, including fever and chills
    • Abnormal bleeding (more than a menstrual period)
    • Foul-smelling vaginal discharge
    • Abdominal pain
    • Nausea, vomiting
    • Cough, shortness of breath, difficulty swallowing, or chest pain
    • Trouble urinating
    • Any other concerns
    In case of an emergency, call for medical help right away.
  • RESOURCES

    The American Congress of Obstetricians and Gynecologists http://www.acog.org/For%5FPatients

    Women's Health.gov http://www.womenshealth.gov

    CANADIAN RESOURCES

    The Society of Obstetricians and Gynaecologists of Canada http://www.sogc.org

    Women's Health Matters http://www.womenshealthmatters.ca

    References

    Hysteroscopy. St. John’s Mercy Health Care website. Available at: http://www.mercy.net/service/hysteroscopy. Accessed December 20, 2012.

    Julian T. Hysteroscopic complications. Journal of Lower Genital Tract Disease. 2002;6:39-47.

    Revision Information

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