Hysteroscopy

________________________________________________________________________

KEY POINTS

• Hysteroscopy is a procedure for looking at the inside of the uterus, the muscular organ at the top of the vagina, to check for causes of bleeding, tumor, or fertility problems.
• Ask your healthcare provider if you need to avoid taking any medicine or supplements before the procedure, and tell your healthcare provider if you have any food, medicine, or other allergies such as latex.
• Ask your healthcare provider how and when you will get your test results and when you can return to your normal activities.

________________________________________________________________________

What is a hysteroscopy?

Hysteroscopy is a procedure for looking at the inside of the uterus with a small lighted tube and camera. The uterus (womb) is the muscular organ at the top of the vagina. Babies develop in the uterus, and menstrual blood comes from the uterus.

Hysteroscopy is a procedure that in many cases can be done safely in your healthcare provider’s office.

When is it used?

This procedure may be done when:

• You have heavy or prolonged bleeding from the uterus that does not get better with other treatments. Your healthcare provider will use the scope to try to see what is causing the problem.
• You have an IUD and the string attached to it is not visible. An IUD is a small plastic or copper device inserted into the uterus to prevent pregnancy. Hysteroscopy may be done to remove the IUD if it’s not in the right position.
• You have had several miscarriages (losses of a pregnancy before 20 weeks). The procedure may be done to help find and treat causes of miscarriage.
• You have a polyp in your uterus. A polyp is a growth that may cause abnormal bleeding, problems getting pregnant, or carrying a baby to term, or it may become cancerous. You may need a hysteroscopy to remove the polyp.
• You have adhesions (bands of scar tissue) inside the uterus. This can cause parts of the wall of the uterus to stick together, causing pain, abnormal bleeding, or trouble carrying a pregnancy. Your healthcare provider may be able to use the scope and another tool to find and remove adhesions.
• You have a fibroid tumor in your uterus. A fibroid tumor is a growth of muscle tissue from the wall of the uterus. The fibroid may press on your bladder or rectum, cause bleeding or pain, or make it hard to get or stay pregnant.
• You have had trouble getting pregnant. Your healthcare provider will be able to examine your uterus and may be able to find a reason for infertility.
• Your healthcare provider wants to take a sample of tissue from the uterus (a biopsy) to check for cancer.

Ask your healthcare provider about your choices for treatment and the risks.

How do I prepare for this procedure?

• You may have a pregnancy test before the procedure.
• Make plans for your care and recovery after you have the procedure. Find someone to give you a ride home after the procedure. Allow for time to rest and try to find other people to help with your day-to-day tasks while you recover.
• Follow your healthcare provider's instructions about not smoking before and after the procedure. Smokers may have more breathing problems during the procedure and heal more slowly. It is best to quit 6 to 8 weeks before surgery.
• You may or may not need to take your regular medicines the day of the procedure. Tell your healthcare provider about all medicines and supplements that you take. Some products may increase your risk of side effects. Ask your healthcare provider if you need to avoid taking any medicine or supplements before the procedure.
• Tell your healthcare provider if you have any food, medicine, or other allergies such as latex.
• Your provider will tell you when to stop eating and drinking before the procedure. This helps to keep you from vomiting during the procedure.
• Follow any other instructions your healthcare provider gives you.
• Ask any questions you have before the procedure. You should understand what your healthcare provider is going to do. You have the right to make decisions about your healthcare and to give permission for any tests or procedures.

What happens during the procedure?

Hysteroscopy may be done in your healthcare provider's office, at a surgical center, or at the hospital.

You will be given local, regional, or general anesthesia to keep you from feeling pain. Local or regional anesthesia numbs part of your body while you stay awake. With local or regional anesthesia you may also be given medicine to help you relax. General anesthesia relaxes your muscles and puts you into a deep sleep.

Your healthcare provider will guide the scope into your vagina, through the cervix, and into your uterus. Gas or fluid may be released through the scope to inflate your uterus. This helps your provider see inside the uterus better. Your provider may use small instruments to remove or get a sample of abnormal tissue.

The procedure may take as little as 30 minutes or as long as 2 hours or more, depending on what your healthcare provider does during the procedure.

What happens after the procedure?

You may stay in a recovery area for a short time before you go home. In rare cases you may stay at the hospital overnight.

After the procedure you may have:

• Cramps for a few hours after the procedure
• Trouble urinating for the first few hours
• Watery or bloody discharge for 3 or 4 weeks

Ask your healthcare provider:

• How and when you will get your test results
• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

What are the risks of this procedure?

Every procedure or treatment has risks. Some possible risks of this procedure include:

• You may have problems with anesthesia.
• You may have infection or bleeding.
• Other parts of your body may be injured during the surgery.
• You may have an allergic reaction to the fluid used during the procedure.

Ask your healthcare provider how these risks apply to you. Be sure to discuss any other questions or concerns that you may have.