Hysteroscopy is a procedure that allows your doctor to look inside your uterus in order to diagnose and treat causes of abnormal bleeding. Hysteroscopy is done using a hysteroscope, a thin, lighted tube that is inserted into the vagina to examine the cervix and inside of the uterus. Hysteroscopy can be either diagnostic or operative.
What is diagnostic hysteroscopy?
Diagnostic hysteroscopy is used to diagnose problems of the uterus. Diagnostic hysteroscopy is also used to confirm results of other tests, such as hysterosalpingography (HSG). HSG is an X-ray dye test used to check the uterus and fallopian tubes. Diagnostic hysteroscopy can many times be done in an office setting. Additionally, hysteroscopy can be used with other procedures, such as laparoscopy, or before procedures such as dilation and curettage (D&C). In laparoscopy, your doctor will insert an endoscope (a slender tube fitted with a fiber optic camera) into your abdomen to view the outside of your uterus, ovaries and fallopian tubes. The endoscope is inserted through an incision made through or below your navel.
What is operative hysteroscopy?
Operative hysteroscopy is used to correct an abnormal condition that has been detected during a diagnostic hysteroscopy. If an abnormal condition was detected during the diagnostic hysteroscopy, an operative hysteroscopy can often be performed at the same time, avoiding the need for a second surgery. During operative hysteroscopy, small instruments used to correct the condition are inserted through the hysteroscope.
When is operative hysteroscopy used?
Your doctor may perform hysteroscopy to correct the following uterine conditions:
- Polyps and fibroids —Hysteroscopy is used to remove these non-cancerous growths found in the uterus.
- Adhesions —Also known as Asherman’s Syndrome, uterine adhesions are bands of scar tissue that can form in the uterus and may lead to changes in menstrual flow as well as infertility. Hysteroscopy can help your doctor locate and remove the adhesions.
- Septums— Hysteroscopy can help determine whether you have a uterine septum, a malformation of the uterus that is present from birth.
- Abnormal bleeding— Hysteroscopy can help identify the cause of heavy or lengthy menstrual flow, as well as bleeding between periods or after menopause. Endometrial ablation is one procedure in which the hysteroscope, along with other instruments, is used to destroy the uterine lining in order to treat some causes of heavy bleeding.
What are the benefits of hysteroscopy?
Compared with other, more invasive procedures, hysteroscopy may provide the following advantages:
- Shorter hospital stay
- Shorter recovery time
- Less pain medication needed after surgery
- Avoidance of hysterectomy
- Possible avoidance of “open” abdominal surgery
How safe is hysteroscopy?
Hysteroscopy is a relatively safe procedure. However, as with any type of surgery, complications are possible. With hysteroscopy, complications occur in less than 1 percent of cases and can include:
- Risks associated with anesthesia
- Heavy bleeding
- Injury to the cervix, uterus, bowel or bladder
- Intrauterine scarring
- Reaction to the substance used to expand the uterus