Hysteroscopy

Hysteroscopy is a procedure that provides a way for the physician to look inside the uterus. A hysteroscope is a thin tube with a light and camera at the end. This scope is inserted into the cervix and uterus through the vagina. A doctor will use the hysteroscope to look for anything abnormal and even take samples from the uterine wall to test for factors that will help diagnose or treat a uterine problem. Hysteroscopy is a minor, outpatient surgery which can be performed with local, regional, or general anesthesia. Sometimes no anesthesia is needed. There is little to no risk involved with this procedure for most women.

There are two kinds of hysteroscopy: diagnostic and operative. Diagnostic hysteroscopy is commonly performed on women who are experiencing heavy menstrual periods and severe cramping; or, it may be ordered if your doctor needs to know more about your reproductive health. Operative hysteroscopy can be used to correct various uterine conditions.

Common reasons for the need for a hysteroscopy are periods that are longer or heavier than usual or bleeding between periods.

You might also need the procedure in these situations:

•     Abnormal Pap test results
•     Bleeding or spotting after menopause.
•     Uterine fibroids, polyps, or uterine scarring
•     More than one miscarriage
•     Problems getting pregnant
•     Sterilization
•     If a tissue biopsy of the uterus is needed
•     To replace a dislodged IUD

A hysteroscopy is an outpatient surgery that is done under either local or general anesthesia. Most hysteroscopies also require medication used to dilate the cervix as well. During the procedure, the doctor will use a speculum inserted into the vagina to keep it open. Next, your doctor will gently insert the hysteroscope through the cervix into the uterus. Saline or gas will then be pushed through the hysteroscope into the uterus to expand the walls so that your doctor will have a clear view of the uterine lining and the opening of the fallopian tubes. If surgery or biopsies are required, small instruments are inserted into the uterus through the hysteroscope.

While a hysteroscopy is used to see the inside of the uterus and the opening of the fallopian tubes, sometimes your doctor will also want to view the outside of these organs. This is done through a procedure called laparoscopy, in which a laparoscope is used at the same time to view the outside of the uterus. In laparoscopy, a doctor will insert an endoscope (a thin tube attached with a fiber optic camera at the end) into your abdomen through a small incision made through or below the navel. Laparoscopy allows your doctor to view the outside of the uterus, ovaries and fallopian tubes.

Operative hysteroscopy is used to correct abnormalities that were detected during a diagnostic hysteroscopy. Diagnostic and operative hysteroscopies can be performed at the same time. During operative hysteroscopy, small instruments used to correct the condition are inserted through the hysteroscope. Hysteroscopy can be used to remove uterine polyps and fibroids, locate and remove bands of uterine scar tissue called adhesions, can determine whether a septum (a malformation of the uterus formed at birth) is present, and can help identify the cause of abnormal bleeding and menstrual flow.

Just like any medical procedure, some complications may arise from a hysteroscopy, including:

• Complications from the anesthesia
• Infection
• Tearing or damage to your cervix (though this is rare)
• Issues as a result of the gas or fluid used to expand the uterus
• Damage to nearby organs like the bladder, bowel, or ovaries
• Pelvic inflammatory disease

Hysteroscopy is a reasonably safe procedure and problems arise in less than one percent of cases. 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.

If you are suffering from uterine pain and heavy or unusual menstrual bleeding, Advanced Gynecology is here for you.

Our board-certified team of women’s health experts are ready to help you with diagnostic care and a range of treatment options.

We will counsel you about the best options for you and your health.