WHAT IS A Hysteroscopy
Hysteroscopy is a surgical procedure in which a long thin camera, or scope, is inserted into the uterus to evaluate the uterine cavity for causes of abnormal bleeding. Hysteroscopy can be performed in the office or in the operating room. It can be diagnostic (just to look and identify the problem) or operative (to look, identify, and remove the problem)1.
Hysteroscopy Procedure Types
An office hysteroscopy is conveniently performed in a physician’s office under local anesthesia. Numbing medication is injected into the cervix and a very thin camera is guided into the uterine cavity.
An office hysteroscopy can identify abnormalities involving the uterine cavity:
- Endometrial polyps
- Masses suspicious for malignancy
A small biopsy can be performed during the evaluation to rule out malignancy. If fibroids or intrauterine adhesions are found, operative hysteroscopy under IV sedation in the operating room will be required.
Operative hysteroscopy removes intrauterine growth (fibroid or polyp), uterine septum, or adhesions. This procedure is performed in the operating room under IV sedation administered by an anesthesiologist.
During the procedure, the cervical canal is dilated and a larger-caliber camera (scope) is guided into the uterine cavity. The uterine cavity is distended with fluid and a heated loop device is then used to cut away the fibroid (hysteroscopic myomectomy), polyp, septum, or adhesions. In cases of large fibroids, uterine septum, or extensive adhesions, several procedures are required for complete removal and should be performed by an experienced surgeon to avoid complications.
One of the risks of operative hysteroscopy is the formation of intrauterine adhesions. In some cases, an intrauterine balloon is placed at the completion of the procedure to decrease bleeding and prevent scarring. The balloon is removed in the office after seven days, and the patient is prescribed high-dose estrogen for several weeks to rebuild a healthy uterine lining and further prevent the formation of intrauterine adhesions.
While recovering from a hysteroscopy:
- You may resume regular activities in one to two days
- Intercourse may be resumed when the spotting has stopped
- Shower as usual but avoid tub baths until the spotting has stopped
- If you have some abdominal cramping, you may take Advil or Tylenol to reduce the pain and discomfort
- Expect vaginal bleeding for a few days and use maxi pads, not tampons, to absorb blood and discharge
- Avoid douching and call the office if you notice a foul-smelling discharge
- You may have regular food as tolerated, no special diet is required.
Hysteroscopy Risks and Complications
Some of the risks and complications associated with a hysteroscopy include:
- Risks associated with anesthesia
- Heavy bleeding
- Injury to the cervix, uterus, bowel, or bladder
- Intrauterine scarring
- Reaction to the substance used to expand the uterus
The CIGC Difference
At The Center for Innovative GYN Care® (CIGC®), we believe doing extensive research before choosing a surgeon is important. Get to know our surgical specialists and see why they are the best in the industry.
When performing any procedure at CIGC, our goals are to:
- Use the smallest number and size of incisions possible
- Reduce complications
- Minimize pain
- Provide the fastest possible recovery
We have performed thousands of laparoscopic procedures for all types of GYN conditions, including fibroids, endometriosis, pelvic masses, pelvic pain, and GYN cancers. We are renowned both nationally and internationally for our results.
Women choose CIGC because GYN surgery is the only medicine we practice. We have made a commitment to performing hysteroscopy and other gynecological procedures, and our specialists are board-certified and fellowship-trained in minimally invasive surgery. We do not use open or robotic procedures, so we can achieve our goals of treating your condition with as little pain as possible.
Our laparoscopic procedures are top-of-the-line, providing the smallest number and size of incisions possible. Rather than having a long, expensive procedure and painful recovery, you will be back on your feet in no time.
Hysteroscopy is rarely painful, but cramps can occur if fibroids are removed from the uterus or surgery is performed. In most cases, recovery is just one day following the procedure.
The cost of hysteroscopy is minimal since it is considered a minor surgical procedure.
D&C is an abbreviation for dilation and curettage, which refers to the dilation of the cervix and scraping, or curettage, of the uterine lining. A hysteroscopy D&C is usually performed to evaluate the cause of abnormal uterine bleeding and, most importantly, to rule out malignancy in postmenopausal patients. This procedure is performed under anesthesia in the operating room.
A hysteroscopy may delay your period by roughly two weeks, either early or late. Since a GYN surgeon will be accessing the uterus and clearing it for inspection during a hysteroscopy, the uterus will need to build a new tissue lining after the procedure.
A hysteroscopy is one method to detect cancer. If an ultrasound or physical examination are inconclusive, a hysteroscopy will provide a more conclusive diagnosis.
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Our specialists are ready to provide an evaluation of your symptoms and conditions and recommend an appropriate solution.
1 Centini G, Troia L, Lazzeri L, et al. Modern operative hysteroscopy. Minerva Ginecol. 2016 Apr;68(2):126-32