Hysteroscopy

Why It Is Done

A hysteroscopy may be done to:

• Find the cause of severe cramping or abnormal bleeding. Your doctor can pass heated tools through the hysteroscope to stop the bleeding.
• See whether a problem in the shape or size of the uterus or if scar tissue in the uterus is the cause of infertility.
• Look at the uterine openings to the fallopian tubes. If the tubes are blocked, your doctor may be able to open the tubes with special tools passed through the hysteroscope.
• Find the possible cause of repeated miscarriages. Other tests may also be done.
• Find and remove a misplaced intrauterine device (IUD).
• Find and remove small fibroids or polyps.
• Check for endometrial cancer.
• Use heated tools to remove problem areas in the lining of the uterus (endometrial ablation).
• Place a contraceptive implant (such as Essure) into the opening of the fallopian tubes as a method of permanent sterilization.

How To Prepare

Tell your doctor if you:

• Are or might be pregnant.
• Are taking any medicines.
• Are allergic to any medicines.
• Take a blood thinner, or if you have had bleeding problems.
• Have been treated for a vaginal, cervical, or pelvic infection in the past 6 weeks.
• Have any heart or lung problems.

It is best to have a hysteroscopy done when you are not having your menstrual period. If there is a chance that you could become pregnant, the hysteroscopy should be done before you are ovulating so your doctor is sure you are not pregnant.

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 need to stop eating and drinking before the test. Follow the instructions exactly about when to stop eating and drinking, or your surgery may be canceled. If your doctor has instructed you to take your medicines on the day of surgery, do so using only a sip of water.

Arrange to have someone drive you home the day of the test in case you are given a sedative.

You will be asked to sign a consent form that says you understand the risks of the test and agree to have it done.

Talk to your doctor about any concerns you have regarding the need for the test, its risks, how it will be done, or what the results will mean. To help you understand the importance of this test, fill out the medical test information form (What is a PDF document?).

The hospital or surgery center may send you instructions on how to get ready for your surgery, or a nurse may call you with instructions before your surgery.

How It Is Done

A hysteroscopy is usually done by your gynecologist in the operating room of a hospital or surgery center. Most women go home the same day. In some cases, the hysteroscopy can be done in your doctor's office.

You may be given medicine (anesthesia) to help you relax, to numb the area, or to help you sleep.

You will take off all of your clothes and wear a gown for the test. You will empty your bladder before the test. You will then lie on your back on an examination table with your feet raised and supported by footrests (stirrups).

Your doctor will insert a lubricated tool called a speculum into your vagina. The speculum gently spreads apart the vaginal walls so your doctor can see inside the vagina and the cervix. Your vagina will be cleaned with a special soap.

The hysteroscope will be placed at the entrance to your vagina and gently moved through the cervix into your uterus. A gas or liquid will be put through the hysteroscope into your uterus to help your doctor see the lining clearly. Your doctor looks through the hysteroscope at a magnified view of the lining of your uterus. Your doctor can also see the uterine openings of the fallopian tubes. A video screen may be used during the test.

If a biopsy or other procedure is done, your doctor will use small tools through the hysteroscope. A hysteroscopy takes about 30 minutes, unless other procedures are being done.

How It Feels

If you are given a sedative or a local or regional anesthesia, you may have some cramping during the test. If you have general anesthesia, you may have a tickling, dry throat, slight hoarseness, or a mild sore throat after the test; these symptoms may last several days. Throat lozenges and warm saltwater gargles can help relieve the throat symptoms.

Some women feel dizzy and sick to their stomachs. This is called a vasovagal reaction. This feeling will go away after a few minutes.

You may need to avoid sexual intercourse, using tampons, or playing sports for a while after hysteroscopy. Talk to your doctor about when you can resume normal activities.

What Affects the Test

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. But it is best to have a hysteroscopy when you are not having your menstrual period.

If you are past menopause, a hysteroscopy can be done anytime.

What To Think About

• Removing uterine fibroids during a hysteroscopy may be possible instead of performing a hysterectomy in some women with abnormal bleeding.
• A hysteroscopy is not recommended for women with cervical cancer or pelvic inflammatory infection.