Hysteroscopy

What is a hysteroscopy?

A hysteroscopy is a procedure that allows a health care provider to look at the inside of a woman's cervix and uterus. It uses a thin tube called a hysteroscope, which is inserted through the vagina. The tube has a camera on it. The camera sends images of the uterus onto a video screen. The procedure can help diagnose and treat causes of abnormal bleeding, uterine diseases, and other conditions.

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 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
• 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.
• Implant a permanent birth control device into the fallopian tubes. Fallopian tubes carry eggs from the ovaries into the uterus during ovulation (the release of an egg during the menstrual cycle).

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 a permanent form of birth control.
• 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 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 type of medicine to help you relax and block the pain. Some women may be given general anesthesia. General anesthesia is a medicine that will make 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 will then insert the hysteroscope into the vagina and move it through your cervix and into your uterus.
• Your provider will inject a liquid or gas through the hysteroscope and into your uterus. This helps expand the uterus so your provider can get a better view.
• 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 was done during the procedure. The medicines you were given may make you drowsy for a while. You should arrange for someone to drive you home after the procedure.

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

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 health care provider. You may need to reschedule.

Also, tell your provider if you are pregnant or think you might be. A hysteroscopy should not be done on pregnant women. The procedure may be harmful to an unborn baby.

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.

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. He or she may also take a 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 health care provider.

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

A hysteroscopy is not recommended for women with cervical cancer or pelvic inflammatory disease.