Hysteroscopy

What is a diagnostic hysteroscopy? 
A diagnostic hysteroscopy is a procedure in which the doctor can look into your uterus. The uterus is a muscular organ at the top of the vagina where menstruation begins and babies grow.

When is it used? 
This operation is performed because of unexplained heavy bleeding or unscheduled bleeding for which there is no explanation. The doctor is usually looking for a polyp, tumor or malignancy. A tissue sample is obtained by D&C (dilation and curettage) to confirm the findings and can often improve your symptoms.

Examples of alternatives are:

• sonohysterogram can look at shadows of polyps or tumors in your uterus.
• choosing not to have treatment.

You should ask your doctor about these choices.

How do I prepare for a diagnostic hysteroscopy? 
Sometimes the procedure can be done in the office. This is reserved for people who have had one or more vaginal deliveries and wish to avoid a general anesthetic and the inconvenience of going to the hospital. If a polyp or thick endometrium (lining of the uterus) is found, a D&C may still have to be scheduled.

Plan for your care and recovery after the operation, especially if you are to have general anesthesia. Allow for time to rest and try to find other people to help you with your duties for the rest of the day.

Follow instructions provided by your doctor. If the procedure is to be done in the office, taking Advil 400 mg about an hour before your appointment will reduce cramping. If you are to have general anesthesia, do not eat or drink anything after midnight and the morning before the procedure. Do not even drink coffee, tea, or water. Avoid any herbal preparations (especially those used for weight control) and aspirin for at least 10-14 days prior to the operation.

What happens during the procedure? 
You are given a local, regional, or general anesthetic. A local or regional anesthetic numbs part of your body while you remain awake. It should keep you from feeling pain during the operation. A general anesthetic relaxes your muscles, makes you feel as if you are in a deep sleep, and prevents you from feeling pain.

The doctor dilates your cervix. He or she places a hysteroscope, a thin telescopelike tube with a light source, up through the cervix into the uterus. The uterus is then inflated with fluid or gas. This allows the doctor to view the inside of your uterus more closely and look for what might be causing your abnormal bleeding.

What happens after the procedure? 
You may stay in the hospital about 1 or 2 hours.

After the procedure you may:

• feel sleepy or groggy from the anesthetic
• have some cramps
• have a bloody or watery discharge for a few days.

Ask your doctor what steps you should take and when you should come back for a checkup.

What are the benefits of this procedure? 
By seeing the condition of your uterus, the doctor can make a more accurate diagnosis and will be able to more effectively treat your problem.

What are the risks associated with this procedure?

• There are some risks when you have general anesthesia. Discuss these risks with your doctor.
• Some of the blood vessels in the lining of the uterus may leak.
• The uterus could be punctured and need surgery to repair it (rare).
• There is a risk of infection and bleeding.
• There is risk of injury to bowel or bladder (rare).

You should ask your doctor how these risks apply to you.

When should I call the doctor? 
Call the doctor immediately if:

• You start to bleed heavily.
• You develop a fever.
• You have a lot of pain in your lower abdomen.