All about a Hysteroscopy Procedure

The procedure explained

Hysteroscopy is used to diagnose or treat problems of the uterus. A hysteroscope is a thin, lighted telescope-like device. It is inserted through your vagina into your uterus. The hysteroscope transmits the image of your uterus onto a screen. Certain things may interfere with a hysteroscopy. These may include:

  • Pelvic inflammatory disease
  • Vaginal discharge
  • Inflamed cervix
  • Bloated bladder

Why is this procedure needed?

One of the most common uses for hysteroscopy is to find the cause of abnormal uterine bleeding. Abnormal bleeding can mean that a woman’s menstrual periods are heavier or longer than usual or occur less or more frequently than normal. Bleeding between periods is abnormal. In some cases, abnormal bleeding may be caused by benign (not cancer) growths in the uterus, such as fibroids or polyps.

Hysteroscopy may be used in the following situations:

  • Adhesion removal from infection or a past surgery
  • Diagnose the cause of repeated miscarriage when a woman has more than two miscarriages in a row
  • Locate an intrauterine device (IUD)
  • Perform sterilization using the hysteroscope to place small implants into a woman’s fallopian tubes as a permanent form of birth control

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How is the hysteroscopy performed?

Before the procedure begins, you may be given a medication to help you relax, or a general or local anesthetic may be used to block the pain. If you have general anesthesia, you will not be awake during the procedure. Hysteroscopy can be done in a health care professional’s office or at the hospital. It will be scheduled when you are not having your menstrual period. To make the procedure easier, your health care professional may dilate (open) your cervix before your hysteroscopy. You may be given medication that is inserted into the cervix, or special dilators may be used. 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 a fluid, such as saline (salt water), will be put through the hysteroscope into your uterus to expand it. The gas or fluid helps your health care professional see the lining more clearly. The amount of fluid used is carefully checked throughout the procedure. Your health care professional 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 tools will be passed through the hysteroscope.

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Diagnostic Hysteroscopy

This procedure used to diagnose problems of the uterus. A diagnostic hysteroscopy is also used to confirm results of other tests, such as hysterosalpingography (HSG). An HSG test uses an X-ray dye to check the uterus and Fallopian tubes. Often, diagnostic tests can be done in an office setting without need for full sedation.

Operative Hysteroscopy

The operative procedure is used to correct an abnormal condition that has been detected during a diagnostic hysteroscopy. If an abnormal condition was detected during the diagnostic hysteroscopy, an operative hysteroscopy can often be performed at the same time, avoiding the need for a second surgery. During operative hysteroscopy, small instruments used to correct the condition are inserted through the hysteroscope.

Are there any risks?

Having a Hysteroscopy procedure done is a very safe. However, there is a small risk of problems as with any procedure. The uterus or cervix can be punctured by the hysteroscope which can cause bleeding, or excess fluid may build up in your system. In very rare cases, hysteroscopy can cause life-threatening problems.

Other possible risks:

  • Infection
  • Bleeding
  • Pelvic inflammatory disease
  • Tearing of the uterus (rare) or damage to the cervix
  • Complications from fluid or gas used to expand the uterus
  • You may have slight vaginal bleeding and cramps for a day or two after the procedure.

Blog Source: ACOG.ORG

What is the recovery like?

If the procedure is done in an outpatient basis, you should be able to go home shortly after the procedure.  It’s normal to have some mild cramping or a little bloody discharge for a few days after the procedure. Medication will be given to help ease the pain if this is the case. Having fever, chills, or heavy bleeding or discharge is cause for concern and your doctor should be informed immediately.

With general anesthesia, you may need to wait until its effects have worn off and have your blood pressure, pulse, and breathing monitored until they are stable and you are alert. When stable, you will be discharged home. Gas may be in your digestive tract from the anesthesia that may cause upper belly and shoulder pain.

Be sure to take only the specified pain relievers as advised by your physician. Aspirin or certain other pain medicines may increase the chance of bleeding. Don’t douche or have sex for 2 weeks after the procedure or advised otherwise. You will be given instructions on when you may resume normal activities. You shouldn’t need any special care after a hysteroscopy.

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