Hysteroscopic surgery; Operative hysteroscopy; Uterine endoscopy; Uteroscopy
Hysteroscopy is a procedure to look at the inside of the womb (uterus). Your doctor can look at:
- The opening to the womb (cervix)
- The inside of the womb
- The openings of the fallopian tubes
This procedure may be done to diagnose or treat a health problem.
Hysteroscopy gets its name from the tool used to view the womb. This tool is called a hysteroscope. It is a thin, lighted tube. It sends images of the inside of the womb to a video monitor.
Before the procedure, you will be given medicine to help you relax and block pain. Sometimes, anesthesia medicine is given to help you fall asleep.
- The doctor places the scope through the vagina and cervix, into the womb.
- Gas or fluid may be placed into the womb so it expands. This helps the doctor see the area better.
- Pictures of the womb can be seen on the video screen.
Small tools can be used through the scope to remove abnormal growths or tissue for examination. Certain treatments, such as ablation, can also be done through the scope. Ablation uses heat, cold, or electricity to destroy the lining of the womb. Another treatment that can be done through the scope is called the Essure procedure. This places coils into your fallopian tubes to block them.
Hysteroscopy can last 15 minutes to more than 1 hour, depending on what is done.
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Why the Procedure Is Performed
This procedure may be done to:
- Treat heavy or irregular periods
- Block the fallopian tubes to prevent pregnancy
- Diagnose abnormal structure of the womb
- Diagnose thickening of the lining of the womb
- Find and remove abnormal growths such as polyps or fibroids
- Find the cause of repeated miscarriages or to remove tissue after a pregnancy loss
- Find uterine or cervical cancer
- Remove an intrauterine device (IUD)
- Remove scar tissue from the womb
- Take a tissue sample (biopsy) from the cervix, womb
This list is not all-inclusive.
Risks of hysteroscopy include:
- Hole (perforation) in the wall of the womb
- Scarring of the lining of the womb
- Damage to the cervix
- Need for surgery to repair damage
Risks of any pelvic surgery include:
- Damage to nearby organs or tissues
- Blood clots, which could travel to the lungs and be deadly (rare)
Risks of anesthesia include:
- Breathing problems
- Lung infection
Risks of any surgery include:
Your doctor will tell you the results of your procedure.
Biopsy results are usually available with 1 to 2 weeks.
Women with heavy periods usually have fewer symptoms when certain treatments are done during hysteroscopy. These include ablation or removal of fibroids or polyps.
After the Procedure
Your doctor may prescribe medicine to open your cervix. This makes it easier to insert the scope. You need to take this medicine about 8 to 12 hours before your procedure.
Before any surgery:
- Always tell your doctor about all the medicines you take. This includes vitamins, herbs, and supplements.
- Tell your doctor if you have diabetes, heart disease, kidney disease, or other health problems.
- Tell your doctor if you are or could be pregnant.
- If you smoke, try to stop. Ask your doctor or nurse for help. Smoking can slow wound healing.
In the 2 weeks before your procedure:
- You may need to stop taking drugs that make it hard for your blood to clot. These include aspirin, ibuprofen (Advil, Motrin), naproxen (Naprosyn, Aleve), clopidogrel (Plavix), and warfarin (Coumadin). Your doctor or nurse will tell you what you should or should not take.
- Ask your doctor or nurse which medicines you can take on the day of your procedure.
- Tell your doctor or nurse if you have a cold, flu, fever, herpes outbreak, or other sickness.
- You will be told when to arrive at the hospital. Ask if you need to arrange for someone to drive you home.
On the day of the procedure:
- You may be asked not to drink or eat anything 6 to 12 hours before your procedure.
- Take any approved drugs with a small sip of water.
You may go home the same day. Rarely, you may need to stay overnight.
- You may have menstrual-like cramps and light vaginal bleeding for 1 to 2 days. Ask your doctor if you can take over-the-counter pain medication for the cramping.
- You may have a watery discharge for up to several weeks.
- You can return to normal daily activities within 1 to 2 days. Do not have sex until your doctor says it is okay.
Lentz G. Endoscopy: Hysteroscopy and Laparoscopy: Indications, Contraindications and Complications. In: Lentz GM, Lobo RA,Gershenson DM, Katz VL, eds. Comprehensive Gynecology. 6th ed. Philadelphia, PA: Mosby Elsevier; 2012:chap 10.