Hysteroscopy

In-Office Procedures, Hospital Procedures

A Hysteroscopy is a technique that is used to look inside the uterus. A hysteroscope is a thin, telescope-like device that is placed into the uterus through the vagina and cervix that helps the doctor diagnose or treat a uterine problem. One of the most common uses for hysteroscopy is to find the cause of abnormal uterine bleeding. This is when a woman's periods are heavier or longer than usual or occur less or more frequently than normal or when bleeding occurs between periods. If your periods are lasting longer than they should or unusually heavy you should call the Woman's Clinic for an appointment.

Most of the time abnormal bleeding is caused by benign (not cancer) growths in the uterus, such as fibroids or polyps. If there are fibroids or polyps found, a special instrument passed through the hysteroscope can be used to remove them. If no growths are found, a tissue sample can be obtained for biopsy. If the sample of tissue does not reveal cancer but the bleeding persists, a hysteroscope with a heated instrument can stop the bleeding by destroying the lining of the uterus.

Hysteroscopy can be done in a doctor's office or at the hospital. It will be scheduled when you are not having your period. To make the procedure easier, your doctor 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.

Before the doctor begins, you may be given a medication to help you relax, or a general or local anesthetic may be used to block the pain. 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 doctor see the lining more clearly. The amount of fluid used is carefully checked throughout the procedure. Your doctor can see 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, your doctor will use small tools through the hysteroscope, such as small scissors or a wire loop.

As with most procedures there are some risks when undergoing a hysteroscopy and your gynecologist will go over the risks and any other instructions. The uterus or cervix can be punctured by the hysteroscope, bleeding may occur, or excess fluid may build up in your system. While it is rare, a hysteroscopy can cause life-threatening problems. Any problems that may arise during or after the procedure can usually be fixed with no additional problems. Be sure to talk with your gynecologist if you have any questions about the risks of hysteroscopy. They will be able to explain in depth how the hysteroscopy is being used to find or treat your condition and what risks you may face. Most of the time, the procedure and recovery time are brief. You should not have hysteroscopy if you are pregnant, have a vaginal or urinary tract infection, or if you have known cancer of the uterus. Your gynecologist will be able to discuss various options and any additional information.