Hysteroscopy

Hysteroscopy at a glance

• Hysteroscopy is a minimally invasive procedure that employs a hysteroscope and is most commonly used to determine the cause of and treat abnormal uterine bleeding.
• A hysteroscope is a narrow lighted telescope-like device with a camera that allows the doctor to look inside of the uterus without making any incisions.
• The hysteroscope is inserted into the vagina, through the cervix, and into the uterus, allowing the surgeon to view, take a biopsy or to use special instruments to treat the underlying condition.
• Hysteroscopy may also be used to remove adhesions, polyps or a malpositioned IUD (intrauterine device).
• The hysteroscope can be used to insert devices in the fallopian tubes for sterilization (permanent birth control).
• Hysteroscopy is performed as an outpatient procedure at Colorado Women’s Health Center, and usually takes an hour or less.

What is hysteroscopy?

A hysteroscopy is a minimally invasive procedure that employs a hysteroscope, a thin, tube device with camera and light. A physician inserts the hysteroscope into the vagina and through the cervix to examine the uterus. Doctors recommend a hysteroscopy if imaging methods, such as ultrasound, haven’t resulted in a diagnosis. A hysteroscopy can also evaluate the cervix along with the uterus. The procedure can be used for both diagnostic and operative purposes.

A hysteroscopy procedure requires no incision and is mostly done on an outpatient basis, generally taking between 30 minutes to an hour. If the surgeon decides to perform treatments during a hysteroscopy, the procedure may take longer. Those types of more complex hysteroscopy procedures may be done in a hospital operating room.

Primary indications for hysteroscopy include abnormal uterine bleeding, longer periods of blood flow, or blood flow that is less frequent or more frequent than normal. A physician may recommend a hysteroscopy to:

• Remove or assess uterine fibroids, polyps or scar tissue
• Evaluate the structure of the uterus
• Locate and remove an intrauterine device (IUD)
• Perform a biopsy
• Investigate bleeding after menopause.
• Place Essure sterilization coils into the fallopian tubes.

Hysteroscopy procedure

To achieve the best results, hysteroscopy is typically scheduled after a patient’s period and before ovulation. The patient may or may not receive anesthesia or a sedative. The hysteroscope is inserted through the vagina, the cervix and into the uterus. Once inside the uterus, saline solution (salt water) is gently pushed into the uterus, expanding the cavity to allow the surgeon a better view. The light and camera feed a video image to a TV monitor the surgeon views as they operate the hysteroscope.

If the surgeon is removing fibroids, cysts or lesions, they insert special instruments through the hysteroscope that can cut, scrape or burn away the unwanted tissue. If a sedative or anesthesia are used during the procedure, the patient may need to stay a few hours at the office to recover but will return home the same day.

Benefits of hysteroscopy

One of the benefits of a hysteroscopy is that a diagnostic procedure can evolve into an operative procedure, eliminating the need for another visit for treatment. Since a hysteroscopy is a minimally invasive procedure, it reduces risks associated with traditional open surgery. These benefits include:

• No hospital stay for most hysteroscopies
• Shorter recovery time
• Reduced need for pain medication
• No incision, no scarring
• Reduced risk of infection and blood loss.

Risks of hysteroscopy

Less than 2 percent of hysteroscopies result in complications for the patient. Rare risks include:

• Reaction to anesthesia, if it is used
• Infection
• Excessive loss of blood
• Injury to the uterus
• Incidental damage to healthy tissue
• Reaction to the liquid used to expand the uterus.