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A hysteroscopy is the visual examination of the canal of the cervix and interior of the uterus using a thin, lighted, flexible tube called a hysteroscope. The device is inserted through the vagina.
A hysteroscopy may be used for diagnostic and therapeutic purposes. The hysteroscope allows for easy visual access to the interior of the cervix and uterus to assess the lining of these structures. Therapeutic maneuvers, such as taking a tissue sample (biopsy), removing polyps or fibroid tumors, or preventing bleeding with cautery (destruction of tissue by electric current, freezing, heat, or chemicals) may be performed during a hysteroscopy procedure.
A diagnostic hysteroscopy may be performed in a physician’s office or in an outpatient facility with local or no anesthesia required. More invasive therapeutic hysteroscopy procedures may be performed in the operating room under local, regional, or general anesthesia
Because the physician is able to see the interior of the cervix and uterus during the procedure, diagnostic hysteroscopy has become a more common procedure than dilation and curettage (D&C), which is performed without endoscopic visualization.
Other related procedures that may be used to evaluate problems of the female pelvic organs include D&C, cervical biopsy, colposcopy, endometrial biopsy, laparoscopy, Pap test, and pelvic ultrasound. Please see these procedures for additional information.
The organs and structures of the female pelvis are:
A hysteroscopy may be performed on women who have an abnormal Pap test, dysfunctional uterine bleeding, or postmenopausal bleeding. It may be used to help diagnose causes of infertility or repeated miscarriages. A hysteroscopy may also be used to evaluate uterine adhesions (Asherman’s syndrome), polyps, and fibroids and locate and remove displaced intrauterine devices (IUDs).
Therapeutically, a hysteroscopy may be used to help correct uterine problems. For example, small adhesions and fibroids may be removed through the hysteroscope, often eliminating the need for open abdominal surgery. Endometrial biopsy or ablation (removal of the endometrial lining) may be performed via a hysteroscopy. The term “operative hysteroscopy” may be used in these situations.
There may be other reasons for your physician to recommend a hysteroscopy.
As with any surgical procedure, complications may occur. Some possible complications of a hysteroscopy may include, but are not limited to, the following:
You may experience slight vaginal bleeding and cramps for a day or two after the procedure.
There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your physician prior to the procedure.
Certain factors or conditions may interfere with a hysteroscopy. These factors include, but are not limited to, the following:
A hysteroscopy may be performed on an outpatient basis or as part of your stay in a hospital. Procedures may vary depending on your condition and your physician’s practices.
Generally, a hysteroscopy follows this process:
Your recovery process will vary depending on the type of anesthesia given. If general anesthesia or a sedative was used, your blood pressure, pulse, and breathing will be monitored until they are stable and you are alert. When stable, you will be discharged to your home. A hysteroscopy is usually performed on an outpatient basis.
Otherwise, there is generally no special type of care following a hysteroscopy.
You may experience cramping and vaginal bleeding for a day or two after the procedure. Report fever, severe abdominal pain, or heavy vaginal bleeding or discharge. Take a pain reliever for soreness as recommended by your physician. Aspirin or other pain medications may increase the chance of bleeding. Be sure to take only recommended medications.
You may be instructed to avoid vaginal douching and sexual intercourse for 2 weeks after the procedure or an alternative period recommended by your physician.
Other activities and normal diet may be resumed unless your physician advises you differently. Your physician may give you additional or alternative instructions after the procedure depending on your particular situation.