Hysteroscopy

Office Hysteroscopy

What is it?

A Hysteroscope is a slender telescopic instrument that is used to let the physician look inside your uterus. The procedure of placing this instrument into your uterus is called Hysteroscopy. It is considered minor surgery and can be performed in the doctor's office or in an operating room.

Why is it ordered?

Hysteroscopy is used to diagnose some abnormalities in the uterine cavity. For example, abnormal uterine bleeding, infertility, repeated miscarriages, adhesions, abnormal growths or displaced IUDs may be evaluated. Hysteroscopy is also used to confirm the results of other tests.

What can I expect before and during the procedure?

The procedure is usually scheduled during the first week or so after a menstrual period, whenever possible. If you are having the procedure done in the Operating Room, you may be asked not to eat or drink anything for a set time before the procedure. Some routine labs may be performed as well. If you are having the procedure done in the physician's office, you may be instructed to take Motrin or Advil to help alleviate cramping during the procedure. The procedure may require local, regional or general anesthesia. The type will depend upon several factors. Your doctor will want to discuss all of your options with you. Your doctor may also prescribe a drug to help you relax.

The opening of your cervix may need to be dilated or made wider with special instruments. The hysteroscope is inserted and a liquid or a gas is usually released through the hysteroscope to expand the uterus making it easier for the physician to see. If additional procedures are to be done, small instruments are inserted through the hysteroscope.

What are the risks and complications?

Hysteroscopy is a relatively safe procedure. In less then 1% of cases* injury to cervix or the uterus, infection, heavy bleeding or side effects of the anesthesia occur. *The American College of Obstetricians and Gynecologists special procedure pamphlet.

What can I expect during my procedure?

If the procedure was done in the office under local anesthesia, you will be able to go home when the physician deems appropriate. Typically within an hour or so. If the procedure was performed under general or regional anesthesia, you may need more recovery time before you go home.

You may feel a pain in your shoulders if gas was used to inflate the uterus. This discomfort will pass quickly as your body absorbs the gas. You may feel faint or nauseous. For a day or two after, you may have vaginal bleeding and cramps. Contact your doctor if you have any of the following side effects:

• Fever
• Severe abdominal pain
• Heavy vaginal bleeding or discharge

Flexible Office Hysteroscopy

What is Flexible Office Hysteroscopy?

Office hysteroscopy is a way of viewing the inside of the uterus by gently inserting an ultra-thin, flexible fiber-optic camera, called a hysteroscope, into the uterus through the vagina. An office hysteroscopy takes place in your doctor's office, instead of under general anesthesia in the operating room. This allows your doctor to identify any problems that may be originating in the uterus much more accurately than a D&C. It is done without making incisions, without anesthesia, and with little discomfort. While the insertion portion of the hysteroscope itself is very, very thin (thinner than the diameter of a pencil), it's advanced optics allow a full color view of the inside of the uterus and the openings to the Fallopian tubes. If your doctor has a video monitor in the room, you will be able to see as well and have your questions answered.

Why would I need Flexible Office Hysteroscopy?

You may be experiencing abnormal uterine bleeding, or A.U.B., usually due to harmless fibroids or polyps in the uterus. AUB can be defined as any significant change in your period. Maybe you've noticed an increase in your flow, or more frequent periods or unexplained spotting or bleeding after menopause. Rather than putting you under general anesthesia just for a diagnostic procedure, your doctor may prefer an immediate diagnosis in the office. Based on what our doctor finds, you and he or she can discuss what method of treatment is best for you-right then and there. Another reason your doctor might suggest an office hysteroscopy is if you have trouble conceiving or suffer from repeated miscarriages. Your doctor might prefer an office hysteroscopy in order to actually see-rather than make an educated guess-if you have adhesions, polyps or fibroids that may be hindering conception or carrying a pregnancy to term. And the more you and your doctor know about what the problem is, the easier it is to treat.

What happens to me during hysteroscopy?

You'll change into a gown and lie on an examination table with your feet in stirrups. Your doctor will check to see if the opening of the cervix needs to be dilated slightly with a special instrument. The hysteroscope is then gently inserted through the vagina and cervix into the uterus. Your doctor will release a small amount of saline solution into the uterine cavity, allowing it to expand so he or she can see more clearly. A light in the hysteroscope allows your doctor to carefully check the walls of the uterus and the openings of the fallopian tubes. The examination takes less than 10 minutes.

Does the procedure hurt?

It causes little discomfort. Most women only feel a minor pinch or very mild cramping.

Are there any side effects from the procedure?

You may experience menstrual-type cramps and bleeding for about 24 hours after a hysteroscopy. Office hysteroscopy is relatively a very safe procedure because it is done under constant visualization. Complications are rare. Instances of infection, heavy bleeding, and injury to the cervix or uterus occur in less than 1% of cases. Should you experience severe abdominal pain, heavy vaginal bleeding or discharge or a fever, get in touch with your doctor. Feel free to discuss office hysteroscopy with your doctor as a patient-friendly option for diagnosis of abnormal uterine bleeding, certain types of infertility and other gynecological problems.

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