Hysteroscopy

What is a hysteroscopy?

A hysteroscopy is a procedure that allows a health care provider to look at the inside of your uterus and cervix. The cervix is the lower part of the uterus (the uterus is the place where a baby grows during pregnancy).

The procedure uses a thin tube called a hysteroscope, which is inserted through your vagina. The hysteroscope is like a telescope with a camera on it. The camera sends images of your uterus onto a video screen.

The procedure may be done to diagnose or treat different uterine diseases, and conditions:

• It's called a diagnostic hysteroscopy when it's done to check for the cause of abnormal uterine bleeding. 
• It's called an operative hysteroscopy when it's done to remove polyps, fibroids, or adhesions. 

Sometimes, you may have both types done at once.

Other names: hysteroscopic surgery, diagnostic hysteroscopy, operative hysteroscopy

What is it used for?

A hysteroscopy is most often used to:

• Diagnose the cause of abnormal uterine bleeding
• Help find the cause of infertility, the inability to get pregnant after at least a year of trying
• Find the cause of repeated miscarriages (more than two miscarriages in a row)
• Find and remove fibroids and polyps. These are types of abnormal growths in the uterus. They are usually not cancerous.
• Remove scar tissue from the uterus. These may be called adhesions and may have formed because of an infection or a past surgery.
• Remove an intrauterine device (IUD), a small, plastic device placed inside the uterus to prevent pregnancy
• Perform a biopsy. A biopsy is a procedure that removes a small sample of tissue for testing.

Why do I need a hysteroscopy?

You may need this test if:

• You are having heavier than normal menstrual periods and/or bleeding between periods.
• You are bleeding after menopause.
• You are having trouble getting or staying pregnant.
• You want to remove an IUD.

What happens during a hysteroscopy?

A hysteroscopy is often done in a hospital or outpatient surgery center. The procedure usually includes the following steps:

• You may be asked to empty your bladder to prepare for the procedure.
• You will remove your clothing and put on a hospital gown.
• You will lie on your back on an exam table with your feet in stirrups.
• An intravenous (IV) line may be put in your arm or hand.
• You may be given a sedative, a medicine that helps you relax and blocks the pain. In some cases, you may need general anesthesia, which makes you unconscious during the procedure. A specially trained doctor called an anesthesiologist will give you this medicine.
• Your vaginal area will be cleaned with a special soap.
• Your provider will insert a tool called a speculum into your vagina. It is used to spread open your vaginal walls.
• Your provider may dilate (expand) your cervix.
• Your provider will then insert the hysteroscope into the vagina and move it through your cervix and into your uterus.
• Your provider may inject a liquid or gas through the hysteroscope and into your uterus. This helps expand the uterus so your provider can view your uterus, uterine lining, and fallopian tubes.
• Your provider will be able to see images of the uterus on a video screen.
• Your provider may take a sample of tissue for testing (biopsy).
• If you are having a uterine growth removed or another uterine treatment, your provider will insert tools through the hysteroscope to perform the treatment.

A hysteroscopy may take 15 minutes to an hour, depending on what is done during the procedure. The medicines you were given may make you drowsy for a while. You should arrange for someone to take you home after the procedure.

Will I need to do anything to prepare for the test?

Your provider will let you know if there are any special instructions. If you will be getting general anesthesia, you may need to fast (not eat or drink) for 6-12 hours before the procedure. Do not use a douche, tampons, or vaginal medicines for 24 hours before the test.

It's best to schedule your hysteroscopy when you are not having your menstrual period. If you get your period unexpectedly, tell your provider. You may need to reschedule.

You may need to stop taking certain medicines before this test, so tell your provider about everything you take. But don't stop taking any medicines unless your provider tells you to.

Also, tell your provider if you are pregnant or think you might be. A hysteroscopy should not be done on pregnant people. The procedure may be harmful to a developing baby. You also shouldn't have a hysteroscopy if you have a pelvic infection.

Are there any risks to the test?

A hysteroscopy is a very safe procedure. You may have mild cramping and a little bloody discharge for a few days after the procedure. Serious complications are rare, but they may include heavy bleeding, infection, and tears in the uterus. Call your provider if you have a fever, severe abdominal (belly) pain, or heavy vaginal bleeding.

After your hysteroscopy, your provider may recommend that you not have sex, use tampons, or douche for two weeks after the procedure. They may also tell you to avoid baths, swimming, or hot tubs during this time.

What do the results mean?

If your results were not normal, it may mean one of the following conditions:

• Fibroids, polyps, or other abnormal growths were found. Your provider may be able to remove these growths during the procedure. They may also take a biopsy, a tissue sample of the growths, for further testing.
• Scar tissue was found in the uterus. This tissue may be removed during the procedure.
• The size or shape of the uterus did not look normal.
• Openings on one or both fallopian tubes are closed.

If you have questions about your results, talk to your provider.

Is there anything else I need to know about a hysteroscopy?

A hysteroscopy is not recommended for people who are pregnant or who have cervical cancer or pelvic inflammatory disease.