Hysteroscopy

If you are experiencing problems like abnormal bleeding, repeated miscarriages or difficulty getting pregnant, your health care provider may recommend a hysteroscopy. A hysteroscopy can help diagnose and treat issues like fibroids, small growths (polyps) and scar tissue.

At Banner Health, we are here to help you understand what happens before, during and after a hysteroscopy and answer any questions you may have.

What is a hysteroscopy?

A hysteroscopy is a medical procedure that allows your gynecologist to look inside the lining of your uterus or womb. They gently insert a hysteroscope, a small, thin tube with a light and tiny camera at the end, through your vagina and cervix to examine the inside of the uterus. 

The test is commonly used to diagnose, investigate and treat gynecological problems. Sometimes, gynecologists may also perform procedures like removing a polyp or fibroid or taking tissue samples (a biopsy) for testing. 

Types of hysteroscopy

The two main types of hysteroscopy are diagnostic and operative:

1. Diagnostic hysteroscopy is used primarily to examine and diagnose. It helps identify issues such as abnormal bleeding, polyps, fibroids or structural problems in the lining of the uterus.
2. Operative hysteroscopy diagnoses and treats problems, such as removing polyps or fibroids and correcting the septum (a wall of tissue in the uterus).

Why may I need a hysteroscopy?

Your provider may recommend a hysteroscopy to find the cause of various problems, such as:

• Abnormal bleeding, such as heavy bleeding, irregular periods, bleeding between periods or after menopause
• Abnormal pap test results
• Abnormal ultrasound findings such as a thickened lining or irregularity of the lining
• Multiple miscarriages
• Difficulties getting pregnant (conceiving)

A hysteroscopy can also be used to:

• Examine and remove polyps, fibroids and scar tissue
• Perform endometrial ablation, a procedure that thins the lining of the uterus to prevent heavy periods
• Find and remove a lost or stuck intrauterine device (IUD) or coil

Who should get a hysteroscopy?

Hysteroscopies are safe and effective procedures for individuals of all ages. However, do not get a hysteroscopy if you:

• Are pregnant or think you may be pregnant
• Have a pelvic inflammatory infection 
• Have cervicitis
• Have other health conditions that could be made worse after a hysteroscopy
• Have a bleeding condition

Let your physician know if you are on blood thinners or medication that thin your blood.   

Possible complications of a hysteroscopy

Hysteroscopies are generally safe procedures, but like any medical treatment they carry potential risks. These risks, though rare, include:

• Vaginal bleeding
• Infection of the uterus or bladder
• Damage or small tear to the uterus
• Reaction to the medication (sedative or general anesthesia) that helps you relax and sleep

If you have any worries or questions about getting a hysteroscopy, it's important to talk to your provider. They’ll help you understand everything and keep you safe during the procedure.

How to prepare for a hysteroscopy

Your provider will give you specific instructions on how to prepare, but here are a few steps to make sure everything goes smoothly:

• Sign a consent form: You may be asked to sign a form giving your provider permission to perform the procedure. Read the form carefully and ask your provider if anything is unclear.
• Adjust medications: Your provider may ask you to adjust or temporarily stop your medications and/or dosage, especially blood thinners, to reduce the risk of bleeding during the procedure. If you have ongoing conditions, such as diabetes or heart disease, your provider will give you specific instructions about your medications.
• Take medication for cervical preparation: Your provider may choose for you to take medication at home before your procedure. This medication is taken to soften the cervix.   
• Avoid vaginal intercourse: Do not have sex for a specific period before the hysteroscopy, as instructed by your provider.
• Make arrangements: Most hysteroscopies done for diagnosis alone are performed in a gynecologist’s office and do not require sedation. For hysteroscopies performed in an operating room, you will typically need sedation or anesthesia. In that case, you will be instructed when to stop eating and drinking. You will also need to have someone take you home afterward.  You will also be given instructions on when you can return to work after this procedure.   

Let your provider know if you have allergies or reactions to medications, latex or tape and if you are pregnant or think you may be pregnant. 

What to expect during a hysteroscopy

How a hysteroscopy is performed may vary depending on your condition and your provider’s practices.

In general, a hysteroscopy follows this process:

• You may be instructed to take ibuprofen or Tylenol up to 30 min to one hour prior to your procedure.
• You may be asked to undress from the waist down and put a hospital gown on.   
• You may be asked to pee right before the procedure.
• You will lie on a bed or table with your head propped up. You’ll likely place your feet in stirrups, similar to a pelvic exam.
• You’ll be given either local or general anesthesia to make you comfortable. In some cases, the cervix is softened with medication as mentioned above and dilated (opened) if needed  before inserting the scope to allow the scope to pass through.
• The hysteroscope is gently inserted through the vagina and cervix into the uterus.
• A small amount of distension fluid may be used to expand the uterus so your provider can better see inside.
• Your provider will examine the uterine lining and may take tissue samples. If lesions like polyps or fibroids are found, surgical instruments can often be used to treat them during the same session.
• When the exam is done, the hysteroscope will be taken out.

The procedure may take five to 60 minutes. Diagnostic hysteroscopy usually takes less time than operative hysteroscopy.

Recovery from a hysteroscopy

After the procedure, you may experience mild side effects, such as mild cramping or spotting (light bleeding) for a few days. Most individuals can resume normal activities within a day or two. Avoid using tampons or having sex for a week or two, as advised by your provider.

If you received sedation or anesthesia, you may feel a little groggy or sleepy for a short time. You will need to have someone bring you home. Your provider will also provide specific instructions on how to care for yourself after the procedure. 

Call your provider immediately if you have any of the following:

• Fever and chills
• Severe stomach pain
• Heavy vaginal bleeding

Call 911 or have someone take you to the nearest emergency department if you experience any of the following:

• Sudden chest pain
• Difficulty breathing and swallowing or gasping for air 
• Sudden loss of consciousness

How do I understand my results?

Your provider will discuss the results of your hysteroscopy with you. If problems are found, they will explain what they mean and discuss the next steps, such as further tests or treatments.

Expert care 

Is a hysteroscopy right for you? Banner Health offers personalized consultations and advanced procedures to support your health and well-being. Contact us today if you have questions about hysteroscopy or other medical procedures.