Hysteroscopy – FAQs

Hysteroscopy is a surgical procedure in which a telescope is inserted inside the uterus to examine the uterine lining for any pathology and serves as a method for surgical intervention (operative hysteroscopy).

• Sub mucous (internal) fibroids
• Scarring (adhesions)
• Endometrial polyps
• Uterine septa and other congenital malformations
• Abnormal gynecological bleeding
• Infertility
• Find and reposition a misplaced intrauterine device (IUD).

Before performing hysteroscopy, a trans vaginal ultrasound and sometimes a hysterosalpingogram (an x-ray of the uterus and fallopian tubes) may be performed to provide additional information about the cavity which can be useful during surgery. It is usually conducted on a day-care basis with either general or local anesthesia and takes about ten minutes to perform.

The first step of hysteroscopy involves cervical dilatation – stretching and opening the canal of the cervix with a series of dilators. Then the hysteroscope, a narrow lighted telescope, is passed through the cervix and into the lower end of the uterus. The doctor systematically examines the lining of the cervical canal; the lining of the uterine cavity; and looks for the internal openings of the fallopian tubes where they enter the uterine cavity – the tubal ostia.

If required, hysteroscopy guided biopsy and curettage (a surgical scraping of the inside of the uterine cavity) is performed after the hysteroscopy and endometrial tissue is sent for pathological examination.

It can treat many of the abnormalities found during diagnostic hysteroscopy at the time of diagnosis. The procedure is very similar to diagnostic hysteroscopy except that operating instruments can be placed into the uterine cavity through a channel in the operative hysteroscope. Fibroid tumors, scar tissue (adhesions), and polyps can be removed from inside the uterus.

• Are or might be pregnant.
• Are taking any medicines.
• Are allergic to any medicines.
• Have had bleeding problems or take blood-thinners, such as aspirin or warfarin.
• Have been treated for a vaginal, cervical, or pelvic infection in the past 6 weeks.
• Have any heart or lung problems.
• Do not douche, use tampons, or use vaginal medicines for 24 hours before the hysteroscopy.
• You may be given a medicine (sedative) to relax you for the test, or general, regional, or local anesthesia can be used. Your doctor will discuss this with you. If you are going to have general anesthesia, you will not be able to eat or drink for 8 hours before the test.
• You will be asked to sign a consent form before the test.

• Patients often have cramping similar to that experienced during a menstrual period; and some vaginal staining for several days. Regular activities can be resumed within one or two days after surgery.

• Sexual intercourse should be avoided for a few days or for as long as bleeding occurs.
• Infection of the uterus or fallopian tubes can result.
• Injury to uterus or surrounding organs.
• Allergic reactions
• Bleeding

Reasons you may not be able to have the hysteroscopy or why the results may not be helpful include:

• Having your menstrual period. Your doctor will not be able to see the lining clearly.
• Being pregnant. A hysteroscopy will not be done if you are pregnant because of the risk to your developing baby (fetus).
• If a vaginal or cervical infection is present.
• If you are not sexually active, a hysteroscopy can be done anytime except during your menstrual period.
• If you are post menopause, a hysteroscopy can be done anytime.