Hysteroscopy enables a physician to look through the vagina and neck of the uterus (cervix) to inspect the cavity of the uterus with an instrument called a hysteroscope. Hysteroscopy is used as both a diagnostic and a treatment tool.
Diagnostic hysteroscopy can be used to help determine the cause of infertility, dysfunctional uterine bleeding, and repeated miscarriages. It can also help locate polyps and fibroids, as well as intrauterine devices (IUDs).
The procedure is also used to investigate and treat gynecological conditions, often done instead of or in addition to performing a dilation and curettage (D&C). A D&C is a surgical procedure that expands the cervical canal (dilation) so that the lining of the uterus can be scraped (curettage). A D&C can be used to take a sample of the lining of the uterus for analysis. However, hysteroscopy has advantages over a D&C because the doctor can take tissue samples of specific areas and view any fibroids, polyps, or structural abnormalities. In addition, small fibroids and polyps may be removed via the hysteroscope (in combination with other instruments that are inserted through canals in the hysteroscope), thus avoiding more invasive and complicated open surgery. This approach is also used to remove IUDs that have become embedded in the wall of the uterus.
There is no research available to indicate that hysteroscopy is performed more or less frequently on any subset of the female population.
The hysteroscope is an extremely thin telescope-like instrument that looks like a lighted tube. The modern hysteroscope is so thin that it can fit through the cervix with only minimal or no dilation.
Before inserting the hysteroscope, the doctor administers an anesthetic. Once it has taken effect, the doctor dilates the cervix slightly, and then inserts the hysteroscope through the cervix to reveal the inside of the uterus. Ordinarily, the walls of the uterus are touching each other. In order to get a better view, the uterus may be inflated with carbon dioxide gas or fluid. Hysteroscopy takes approximately 30 minutes.
Treatment involving the use of hysteroscopy is usually performed as a short-stay hospital procedure with regional or general anesthesia. Tiny surgical instruments may be inserted through the hysteroscope to remove polyps or fibroids. A small sample of tissue lining the uterus is often removed for examination, especially if the patient has experienced any abnormal bleeding.
If the procedure is performed under general anesthesia, the patient should have nothing to eat or drink after midnight the night before the procedure. Routine lab tests may be ordered if the procedure is performed in a hospital. Occasionally, a mild sedative is administered to help the patient relax. The patient is asked to empty her bladder. She is then placed in position (usually in a special chair that tilts back) and the vagina is cleansed. Usually, a local anesthetic is administered around the cervix, although a regional anesthetic that blocks nerves connected to the pelvic region or a general anesthetic may be required for some patients.
It is normal to experience light bleeding for one to two days after surgical hysteroscopy. Mild cramping or pain is common after operative hysteroscopy, but usually diminishes within eight hours. If carbon dioxide gas was used, the resulting discomfort usually subsides within 24 hours.
Diagnostic hysteroscopy rarely causes complications. The primary risk is infection. Prolonged bleeding may follow a surgical hysteroscopy to remove a growth. Another complication is perforation of the uterus, bowel, or bladder, caused by over-forceful advancement of the hysteroscope. An infrequent but dangerous complication is increased fluid absorption from the uterus into the bloodstream. Keeping track of the amount of fluid used during the procedure can minimize this complication. Surgery under general anesthesia poses the additional risks typically associated with this type of anesthesia.
The procedure is not performed on women with acute pelvic inflammatory disease (PID) due to the potential of exacerbating the condition. Hysteroscopy should be scheduled after menstrual bleeding has ended and before ovulation to avoid a potential interruption of a new pregnancy.
Patients should notify their health care provider if, after the hysteroscopy, they develop any of the following symptoms:
Normal hysteroscopy reveals a healthy uterus with no fibroids or other growths. Abnormal results include uterine fibroids, polyps, or a septum (an extra fold of tissue down the center of the uterus). Sometimes, precancerous or malignant growths are discovered.
The rate of complications during diagnostic hysteroscopy is very low, about 0.01%. Surgical hysteroscopy is associated with a higher number of complications. Perforation of the uterus occurs in 0.8% of procedures and excess bleeding in 1.2–3.5% of cases. Death as a result of hysteroscopy occurs at a rate of 2.4 per 100,000 procedures performed.
A laparoscope (an instrument with a video camera inserted through the abdominal wall) may be used to visualize the outside of the uterus or perform a surgical procedure on the pelvic organs. Laparoscopy and hysteroscopy are sometimes performed simultaneously to maximize their diagnostic capabilities.
Pagana, Kathleen D., and Timothy J. Pagana. Diagnostic Testing and Nursing Implications. 5th edition. St. Louis: Mosby, 1999.
Murdoch, J. A., and T. J. Gan. "Anesthesia for Hysteroscopy." Anesthesiology Clinics of North America 19, no. 1 (March 2001): 125–40.
Neuwirth, R. S. "Special Article: Hysteroscopy and Gynecology: Past, Present, and Future." Journal of American Association of Gynecology Laparoscopy 8, no. 2 (May 2001): 193–8.
American College of Obstetricians and Gynecologists. 409 12th St., S.W., P.O. Box 96920, Washington, DC 20090-6920. http://www.acog.org/ .
Gordon, A. G. "Complications of Hysteroscopy." Practical Training and Research in Gynecologic Endoscopy. February 17, 2003 [cited March 13, 2003]. http://www.gfmer.ch/Books/Endoscopy_book/Ch24_Complications_hyster.html .
Maggie Boleyn, RN,BSN
Stephanie Dionne Sherk
The test is usually performed by a gynecologist, a medical doctor who specializes in the areas of women's general health, pregnancy, labor and childbirth, and prenatal testing. Nursing staff assists with providing education, positioning the patient, and specimen collection. Diagnostic hysteroscopy is performed in either a doctor's office or hospital. Uterine size and potential diagnosis and complexity of treatment determine the setting.
Thanks
Tania
Is there any possibility of viral transmission? Thank you
M Harding [in England]
Can anyone recommend a specialized doctor to perform this procedure? I live in Rockville Centre, Nassau, NY?
Thank you and good luck to the writers above. God bless all!
I had a hysterosalpingogram the result show the right fallopian tube was identified appear patent with spillage into the peritoneal cavity however the contrast accumulad into a rounded collection possible suggestive peritule adhesion
The left tube was partially seen however no spillage was identified from the left fallopian tube into the peritoneal cavity consistent with blookage
My Dr suggest correlation of findings with hysteroscopy and endovaginal ultrasaund
Is their any chances to conceived successfully after the surgery procedure?
Thanks
Karen
t been able to work due to severity of bleeding and pain. would love any information that could be handy.
Thanks Shezza
Has anyone found out how to stop the pain the shoulder and diaphram from the gas?
Again in 2009 my periods were once in 3 months.In 2010 January I had mild flow for only 3 days and nine months. Later in October i had mild discharge for only two days with slight abdominal pain which was bearable.
My Doctor feels that I shouldn't have had these two periods in 2010, as i am 56. Hence a trans vaginal scan was done to check ovaries & Endometrial thickness.The result was a 1 c.m endometrial thickness,maogins - normal,coarse myometrial echo pattern,and the rest were normal.
Due to the 1 c.m thickness the doc wanted me to do a Hysteroscopy and D & C.
Is it advisable to get a Hysterectomy done once & for all with out going through Hysteroscopy and D&C ? Because if malignancy is found, I will have to undergo a Hysterectomy.
please advice.
Thanks,
Deana
Kayla Tess
A few days from now I am having a ablation done will this finally bring me back to normal? I am so tired of this I just want it to stop. I just feel like I should have a permanent seat on the toilet, please tell me!
You sound like me I've had a Hysteroscopy and D &C back in November. Have polyps removed and my uterus scraped. Since this was done I've been bleeding and not at all impressed. The doctor says I need a full abdominal hysterectomy. My mother died from ovarian cancer 3 years ago. Have not bled for almost 24 years before I was pregnant with my third child. Big shock to the system to be bleeding after all this time...Do not know how long this will last. Doctor wants me to wait 6 months after the previous surgery. There was no sign of cancer. We are going on an overseas trip in March 2012 and I'm hoping this thing has settled down a bit. . Does anyone know or have experienced bleeding like this after the procedure. Thought by now it would have stopped.
Just wondering if I can still have it done on the 4th day of my period i will close to not being on my period cause I only spot on the 4th day please help me ease my mind
Firstly as she pushed the hysteroscope in I felt strong period like cramping. Then as she pushed it, I felt a bit of pain rather like a knitting needle, fortunately this did not last long. I started to feel crampy, felt like vomiting, swearty and fainty. However, that was the worst bit only and the rest was ok. It was quite quick phew but uncomfortable.
Afterwards the nurse designated to me made a cup of tea.
I didn't have a car so didn't drive back but I had a friend who stayed with me 24 hours
I was taken home by bus. I walked slowly. As it was a hot day and my body was slightly in shock, I felt a bit faint and sick.
However, I stayed somewhere cool and got on the train home which also rested me. I felt much better after that. I had some blood afterwards but that is normal.
It really is worth doing, cancer has a lot worse pain.
I don't recommend driving and make sure your motor insurance company is aware.
I had a D&C and a Hysteroscopy done on June 29th, 2012 at the Victoria Hospital in Winnipeg, Manitoba, Canada by Dr. Raina Best- OB/GYN.
The reason for my procedure was that I had slight bleeding and showing in January 2012 for several days and again in February 2012 for two days. I had not had a period for 16 months prior to this.
It was a very simple, easy and pain free experience. I went in to the hospital's day surgery unit in the morning and was hooked up to an I.V.
I was given a very small dose of anesthetic to relax me, but I was awake for the procedure. I was in the operating room for about 15 minutes and back to recovery for two hours.
I had very little bleeding and no pain. No need to take a single pain releiver!
The medical staff were very good at explaining the procedure.
Dr. Best came to see me after the procedure and told me that everything looked normal and all went well. Great relief! She also gave me a note to confirm. She said that she will call me once the pathology report comes back in six weeks. Such a long time to wait, but I feel good knowing the Doctor (who does many of these) was happy with the procedure and could not see anything that concerned her.
I left two hours after the day surgery and went to lunch and shopping with my daughter.
I know that they need to prpeare you for the procedure, but consider it a gift if you feel as good as I did afterwards. I hope my comment will help to ease others minds before the procedure.
Put under with Propofal as well as Versped and other drugs. The procedure was only 35 min. Dr also performed a D&C. A small polyp was removed. I was fine for the first 5 hours or so, but then both my hands went to sleep. I went to ER and I was shock from Anesthetic. My pulse was rapid, shortness of breath, numbness in extremities. They kept me in ER for 5 hours, and tested for blood clots, emblemism..etc. my back has been killing me every since and now abdominal pain. I still have not gone back to work after 4 days and only expected to be off 2 days.
Anyone's experience similar?
A bit tender and sore but feel okay - feel better than when I had heavy periods and large blood clots. Taking it easy for a few more days at home as work is quite hectic. Just on the computer, watching tv and resting. Hung out some washing as well.
For all of you reading this, please take care and seek other advice from health professionals. You need to have absolute trust in your medical help.
She read right11 cm by something and left 12 cm by something upon on viewing the Fallopian tubes does any one know if that is a normal size?
I cannot remember what it feels like to be normal..I woke up during the surgery unable to breathe and it is doing my head in
Changed.I started having pain around my waist,spreading to my legs and my back.could I have been infected during the procedure?I am also bleeding?has anyone been in this position or had similar experience?what did you do?
Is the common?
A few years later, bleeding increased, more frequent, so tests (trans-vaginal ultrasound, urodynamic tests) but nothing of concern. However, since I was undecided about a hysterectomy, a D&C/Hysteroscopy was done about 10 days ago. Had a spinal, which is good in many ways as you have no pain during procedure, stay awake, aren't "loopy" after, no headache, nausea (at least for me) BUT it takes hours to unthaw - about 7 hrs. for me. You can't walk if your feet are numb & don't feel the floor under you, & nurses wouldn't let me leave until I could walk, & urinate (again, bladder is frozen for a long time) so that part was a little frustrating. However, I was perfectly comfortable, & relaxed, ate a sandwich about 2-3 hrs. after surgery. I was warned I would have a backache, from being in that position, but it wasn't that bad & I rested & took it easy & felt fine for 2-3days afterward. Cramps didn't even begin for me until 3 days after, & not severe but still persist, 10 days later, & there has been a light, steady, bloody, vaginal discharge ever since. Feeling well overall, but still looking forward to being rid of this bleeding. The doctor removed a small polyp, which she doesn't feel is of concern.She plans to have me using Premarin now. No lab results for 6 wk. after. For me, not a bad experience so far. My greatest discomfort is from my (severe)prolapse, as without any internal support (pessary) It's hard to be on my feet for long. Since we were instructed not to use tampon, bath, use hottubs, have sex, or put anything in the vagina, I can't use a pessary yet. So, that's my experience. We are all different, & respond differently. I am healthy, generally, underactive thyroid, some allergies, about 25 lbs. overweight, but good for my age. Hope this helps someone.
I had a D&C with Hysteroscopy on May 10th. I had a very this uterus wall and polyps removed. Before this I have been having abnormal spotting since Feb 2016. My doctor put my on birth control to stop the spotting. I would like to know how long is too long to be spotting after a D&C? This has been going on for some time now and I feel like it is ruining my life. I was supposed to got to have a IUD put in tomorrow but the side effects scared me and th chance of me still bleeding is a turn off. When will this stop
If you have concerns/questions before or after:
Don't be afraid to call your doctor or at least his staff, they're there to make you comfortable and address your concerns pre- and post-procedure. Write down your questions or concerns to get them addressed. Ask them to repeat or simplify their responses to ease your mind. You may not recall instructions immediately following procedure, ask for written instructions.
If you are running a fever or bleeding excessively (changing a pad more than hourly), have bright red blood, or foul-smelling discharge, go in to be seen. If GYN won't see you, go to Emergency or Urgent Care!
If you frequently have the sensation of needing to urinate but are empty, especially if you are running a fever, be checked for bladder infection.
Try not to worry. 😊 I wish you all the best! Hope this helps someone.
If you have concerns/questions before or after:
Don't be afraid to call your doctor or at least his staff, they're there to make you comfortable and address your concerns pre- and post-procedure. Write down your questions or concerns to get them addressed. Ask them to repeat or simplify their responses to ease your mind. You may not recall instructions immediately following procedure, ask for written instructions.
If you are running a fever or bleeding excessively (changing a pad more than hourly), have bright red blood, or foul-smelling discharge, go in to be seen. If GYN won't see you, go to Emergency or Urgent Care!
If you frequently have the sensation of needing to urinate but are empty, especially if you are running a fever, be checked for bladder infection.
Try not to worry. 😊 I wish you all the best! Hope this helps someone.
Valeria from Alton Texas
will you please tell that if uterus is small then it effects pregnancy? Means to conceive a baby is not possible if uterus is small?
Secondly, does hysteroscopy is helpful to diagnose the size of uterus?
Please do reply on my email
I had hysteroscopy today and a polyp was removed. After about a month of pelvic pain, I am free of the pain, it feels so good. I also had a D&C. I am hoping that the test results come back normal after some post menopausal bleeding. I am 55years old. Everyone, please hold hope.
Petra
has thickened and i have a polyp. Im 62 healthy and active. Im very concerned about them puncturing my uterus wall and puncturing my bowels, etc. Doctor advised me that it could happen but normally doesnt. Im hoping for the best, but Im very stressed about it. Hope everyone here is doing better.
rior to my op i had no bleeding whatsoever..Thanks
Slight cramping, stinging from the coil, achy back and shaky hands is all I have now, finding it difficult to walk or stand for longer than 3 mins at the moment but this will ease, at least I can now stop dreading my period with the excruciating pain and worrying about what to wear!
Go to a professional if you need one done, don't put up with pain and discomfort, if you are lucky enough to afford private care, then even better
Questions
Is it common for women to be given medicine to stop bleeding after a hysteroscopy operation to remove a fibroid and have a uterus scrap (my wife was prescribed medicine for this reason straight after her operation)? I would have thought it would be better to leave alone so any problems can be acurrately diagnosed..
Her second bout of medicine finished yesterday and she is scared that bleeding will start again. Does anybody know if it iscommon for a patient to bleed fifteen days after such an operation?
Also, is it possible to check the WHOLE uterus for cancer? Here in China the doctors told my wife that sample scapes taken from the uterus cannot in themselves prove that the f the whole of the uterus is cancer free (she has had no cancer findings thus far).
I'd like to thank the people who set up this forum.
I am afraid of the after effects from the procedure and the anesthesia.
My anesthesiologist and OB/GYN said I will be fine. Any comforting responses?
But they didn't say anything.