Hysteroscopy

Hysteroscopy is the inspection of the uterine cavity by endoscopy with access through the cervix. It allows for the diagnosis of intrauterine pathology and serves as a method for surgical intervention.

If you’re having heavy menstrual periods and severe cramping, or your doctor needs to know more about your reproductive health, they may recommend you have a hysteroscopy. The procedure can give them an up-close look at your cervix and uterus and help them learn what’s causing problems.

Why Would I Need the Procedure?

During a hysteroscopy, your doctor inserts a hysteroscope — a thin tube with light on the end — into your vagina. They’ll be able to see into your cervix and inside your uterus. If they find anything abnormal, they can take a sample for later testing.

Among the most common reasons for a hysteroscopy are periods that are longer or heavier than normal, or bleeding between periods.

You might also need the procedure in these situations:

• Your Pap test results are abnormal.

• You’ve been bleeding after menopause.

• There are fibroids, polyps, or scarring on your uterus.

• You’ve had more than one miscarriage or problems getting pregnant.

• Your doctor needs a small tissue sample (biopsy) of the lining of your uterus.

• You’re having a sterilization procedure as a permanent form of birth control.

• Your IUD has come out of place.

How is It Done?

A hysteroscopy can either be in a hospital or at your doctor’s office. You can be either awake or under general anesthesia during the procedure. If you’re awake, your doctor will give you medicine to help you relax. They’ll also use medication or tools called dilators to help open your cervix.

Your doctor will likely use a tool called a speculum to keep your vagina open. If you’ve ever had a Pap smear, your doctor has probably used one during that procedure, too.

Next, they’ll gently insert the hysteroscope through the cervix into your uterus and push gas or a liquid-like saline through the hysteroscope into your uterus to expand it. This will give them a clear view of its lining and the opening of your fallopian tubes through the hysteroscope.

After the Procedure

You’ll probably be able to go home soon after. But if you received local or general anesthetic, you’ll need someone to drive you.

For a few days after the procedure, you may have some mild cramping or bleeding. You might also have gas that can last for about 24 hours. Your doctor may give you medicine to help with any pain. You’ll have to avoid sex for at least 2 weeks after the procedure. Before you’re sent home, your doctor will tell you more about how to take care of yourself after surgery.

What Are the Risks?

Just like any medical procedure, you could have some complications from a hysteroscopy, including:

• Problems from the anesthesia

• Infection

• Tearing or damage to your cervix, though this is rare

• Problems with gas or fluid from the uterus

• Damage to nearby organs like the bladder, bowel, or ovaries

• Pelvic inflammatory disease

If you experience symptoms like a fever, severe abdominal pain, or heavy bleeding after the procedure, call your doctor immediately or go to the emergency room.