Hysteroscopy
Definition
A hysteroscopy is a procedure that allows the doctor to see inside the uterus. A long thin scope is passed through the vagina. The scope has a camera which sends images to a screen in the room. Tools may also be passed with the scope to take samples or do treatment.
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Reasons for Procedure
Hysteroscopy may be done to look for causes of:
- Repeated miscarriages
- Infertility
- Abnormal Pap test
- Abnormal or postmenopausal bleeding
Hysteroscopy may also be done as part of treatment. It may be used to remove:
- Polyps
- Uterine fibroids—called myomectomy
- Intrauterine devices (IUDs)
- Uterine lining—endometrial ablation
Possible Complications
Complications are rare but all procedures have some risk. The doctor will review a list of possible problems such as:
- Swelling or bleeding
- Infection
- Organ injury
- Reaction to anesthesia
The risk of problems is higher with:
- Smoking
- Drinking
- Chronic disease such as diabetes or obesity
- History of pelvic inflammatory disease
- Inflammation of the cervix
- Distended bladder
- Pregnancy or possible pregnancy
What to Expect
Prior to Procedure
The doctor will ask about:
- Past health
- Any medicines you take
- Any allergies you may have
Leading up to the procedure:
- You may be asked to stop taking some medicines up to 1 week before the procedure.
- Arrange to have someone drive you home. Arrange for help at home after.
- Eat a light meal the night before the surgery. Do not eat or drink anything after midnight.
Anesthesia
There are different choices for anesthesia. The choice will depend on what is being done. Options include:
- General anesthesia—blocks pain and keeps you asleep
- Regional anesthesia—lower half of the body will be numb
- Local anesthesia—numbs a small area; a second medicine may also be given to help you relax
Description of the Procedure
A speculum is placed in the vagina. It will gently press open the vagina. A scope will be passed through the vagina and into the uterus. The uterus will be filled with a gas or liquid. This will let the doctor get a clear look inside the uterus.
Other tools may be passed into the uterus. Abnormal tissue will be removed or repairs will be made. A sample of tissue may be removed for a biopsy. All samples will be sent to a lab for exam.
How Long Will It Take?
About 15 to 45 minutes
How Much Will It Hurt?
You will have mild cramping and soreness. Medicine can help with discomfort.
Post-procedure Care
The care team will watch for any problems. Once you feel better, you will be able to go home. Most can go back to normal activity within a few days. Full recovery will depend on what was done.
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
If you think you have an emergency, call for emergency medical services right away.
RESOURCES:
The American Congress of Obstetricians and Gynecologists
http://www.acog.org
Office on Women's Health
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:
Centini G1, Troia L, Lazzeri L, Petraglia F, Luisi S. Modern operative hysteroscopy. Minerva Ginecol. 2016 Apr;68(2):126-32.
Hysteroscopy. American College of Obstetricians and Gynecologist website. Available at: https://www.acog.org/Patients/FAQs/Hysteroscopy. Updated October 2018. Updated January 7, 2019.
Hysteroscopy. NHS website. Available at: https://www.nhs.uk/conditions/hysteroscopy/. Updated May 2018. Updated January 7, 2019.
Last reviewed September 2019 by EBSCO Medical Review Board Mary-Beth Seymour, RN Last Updated: 9/25/2020