Hysteroscopy

A hysteroscopy is a procedure used by the fertility specialist to view the inside of a woman’s uterus (womb). This test is often done when a woman is having problems conceiving a child.

 

What can the doctor look at with the hysteroscopy?

The fertility specialist can view:

  • The cervix (opening of the uterus)
  • The internal tissues of the uterus
  • The openings of the fallopian tubes

 

Why is the hysteroscopy done?

The fertility specialist uses hysteroscopy to diagnose bleeding problems, remove fibroids, tumors, and polyps, and perform certain procedures for sterilization.

 

What conditions are treated using the hysteroscopy technique?

The fertility specialist can treat:

  • Irregular or heavy menses
  • Blocked fallopian tubes
  • Abnormal growths (fibroids and polyps)
  • Thick uterine lining
  • Abnormal womb structures
  • An intrauterine device (IUD) that requires removal
  • Uterine or cervical cancer
  • Womb scar tissue

 

How do I prepare for the hysteroscopy?

The fertility specialist will discuss the pros and cons of the procedure and ask you to sign a consent form. A medication will be given to open the cervix, and it must be taken 8-12 hours before your scheduled procedure. When you arrive at the fertility clinic, a nurse will have you change into a gown and place an IV catheter in your arm. The doctor gives you a medication that blocks pain and helps you relax. Be sure to bring someone with you to drive you home.

 

How is the hysteroscopy procedure done?

The hysteroscope is a thin, lighted tool that goes into the uterus and sends images to a video screen monitor. The doctor gently inserts this scope into the vagina, through the cervix opening, and into the womb. A fluid or gas is often injected into the uterus to expand it for better viewing.

The fertility specialist views the structures and makes a treatment decision. To remove abnormal growths, small tubes are inserted through the scope. For heavy bleeding, the doctor may perform an ablation, which uses electric current or heat to destroy the endometrium (uterine lining).

 

Can the fallopian tubes be unblocked using the hysteroscopy?

The doctor can visualize the fallopian tubes with the hysteroscope. Another procedure done using this scope is the Essure technique. The doctor places coils in the tubes to block them and prevent further pregnancy. He may also remove scar tissue from the tubes to unblock them.

 

What risks are associated with the hysteroscopy?

The hysteroscopy is a safe procedure when performed by a skilled practitioner. However, as with all minimally invasive procedures, there are certain risks, such as:

  • Scarring of the endometrium
  • Cervical damage
  • Perforation of the uterus wall
  • Infection
  • Bleeding

 

What can I expect after the procedure?

It is normal to have light bleeding for 1-2 days following a hysteroscopy. Pelvic discomfort and mild cramming is also common, but this resolves within 4-8 hours. When gas is used to open the uterus, mild abdominal bloating is common. You must rest the remainder of the day following the procedure, and gradually return to normal activities. Avoid heavy lifting or strenuous activities for a few days and follow discharge instructions.

 

What is an alternative to the hysteroscopy?

The laparascope is an instrument with a video camera inserted through a small incision through the abdominal wall. The laparoscopy may be done along with the hysteroscopy. This allows the doctor to visualize the outside of the uterus and other pelvic organs so he can make necessary repairs.