Patient education: Hysteroscopy (The Basics)

What is hysteroscopy? — A hysteroscopy is a procedure that lets a doctor see inside the uterus (figure 1).

During a hysteroscopy, the doctor uses a thin tube with a tiny camera on the end. This is called a "hysteroscope." It goes into the vagina, through the cervix, and into the uterus.

Hysteroscopy can be done for many reasons. For example, your doctor might want to:

●Learn more about or treat abnormal bleeding from your uterus

●Take out an intrauterine device ("IUD")

●Remove scar tissue, polyps, or other tissue from inside your uterus

●Look at the shape of your uterus

●Take a small sample of tissue called a "biopsy"

A hysteroscopy is done in an operating room or clinic.

How do I prepare for a hysteroscopy? — The doctor or nurse will tell you if you need to do anything special to prepare. In some cases, the doctor will give you medicine to help dilate your cervix the night before your procedure.

Before your procedure, your doctor will do an exam. They might send you to get tests, such as:

●Lab tests, including a pregnancy test

●Ultrasound or other imaging tests – Imaging tests take pictures of the inside of the body.

Your doctor will also ask you about your "health history." This involves asking you questions about any health problems you have or had in the past, past surgeries, and any medicines you take. Tell them about:

●Any medicines you are taking – This includes any prescription or "over-the-counter" medicines you use, plus any herbal supplements you take. It helps to write down and bring a list of any medicines you take, or bring a bag with all of your medicines with you.

●Any allergies you have

●Any bleeding problems you have – Certain medicines, including some herbs and supplements, can increase the risk of bleeding. Some health conditions also increase this risk.

●When your last menstrual period was

You will also get information about:

●Eating and drinking before your procedure – In some cases, you might need to "fast" before your procedure. This means not eating or drinking anything for a period of time. In other cases, you might be allowed to have liquids until a short time before the procedure. Whether you need to fast, and for how long, depends on the procedure you are having.

●What help you will need when you go home – For example, you might need to have someone else bring you home or stay with you for some time while you recover.

Ask the doctor or nurse if you have questions or if there is anything you do not understand.

What happens during a hysteroscopy? — When it is time for the procedure:

●You might get an "IV," which is a thin tube that goes into a vein. This can be used to give you fluids and medicines.

●You might be awake for the procedure, or you might get "sedative" medicines. These make you relax and feel sleepy.

●You might get anesthesia medicines to help with pain during or after the procedure. In some cases, the doctor might suggest that you take ibuprofen (sample brand names Motrin, Aleve) to help with pain.

●The doctors and nurses will monitor your breathing, blood pressure, and heart rate during the procedure.

●The doctor might need to open, or "dilate," your cervix to insert the hysteroscope. (The cervix is the bottom part of the uterus, where it meets the vagina.)

●The doctor will put the hysteroscope through your cervix into your uterus. They will fill your uterus with a special fluid or gas.

●The doctor will use the camera to look at the inside lining of your uterus.

●The doctor might do a test called a biopsy. For a biopsy, they take a small piece of tissue from your uterus. Then, they look at the tissue under a microscope to check for cancer or inflammation.

●The doctor might remove an IUD, abnormal tissue, or polyps from your uterus.

●When they are done, the doctor will remove any gas or fluid from your uterus and take out the hysteroscope.

What happens after a hysteroscopy? — After your procedure, you will be taken to a recovery room. The staff will watch you closely as your anesthesia wears off.

As you recover:

●You might have light bleeding, or "spotting," from your vagina. This can last for a few days.

●You might also have mild cramping for a few days. You can take a pain-relieving medicine such as acetaminophen (sample brand name: Tylenol) or ibuprofen (sample brand names: Advil, Motrin).

●Your doctor or nurse will tell you when you can go back to your usual activities. They will also tell you when it is safe to have sex and put things, such as tampons, in your vagina.

●Your doctor will probably recommend that you do not drive or go to work for the rest of the day.

What are the risks of hysteroscopy? — Your doctor will talk to you about all of the possible risks, and answer your questions. Possible risks include:

●Infection

●Injury to the uterus or cervix

●Injury to the bowel or bladder

●Bleeding

●Embolism (when a bubble of gas enters the bloodstream)

What follow-up care do I need? — The doctor will want to see you again after your hysteroscopy to check on your progress. Go to these appointments.

If you had a biopsy, your doctor will let you know when your results are ready and discuss what they mean.

When should I call the doctor? — Call for advice if:

●You have a fever of 100.4°F (38°C) or higher, or chills.

●You have shortness of breath or chest pain.

●You have heavy vaginal bleeding for more than an hour. (This means bleeding that is heavier than a menstrual period, or that completely soaks a large sanitary pad.)

●You have bad-smelling, green, or dark yellow vaginal discharge.

More on this topic

Patient education: Heavy periods (The Basics)
Patient education: IUD removal (The Basics)
Patient education: Dilation and curettage (D&C) (The Basics)
Patient education: Endometrial ablation (The Basics)
Patient education: Uterine fibroids (The Basics)

Patient education: Abnormal uterine bleeding (Beyond the Basics)
Patient education: Heavy or prolonged menstrual bleeding (menorrhagia) (Beyond the Basics)
Patient education: Dilation and curettage (D&C) (Beyond the Basics)
Patient education: Uterine fibroids (Beyond the Basics)