Hysteroscopy
Test Overview
A hysteroscopy is a way for your doctor to look at the lining of your uterus. He or she uses a thin viewing tool called a hysteroscope. The tip of the hysteroscope is put into your vagina and gently moved through the cervix into the uterus. The hysteroscope has a light and camera hooked to it so your doctor can see the lining (endometrium) on a video screen.
A hysteroscopy may be done to find the cause of abnormal bleeding or bleeding that occurs after a woman has passed menopause. It also may be done to see if a problem in your uterus is preventing you from becoming pregnant (infertility). A hysteroscopy can be used to remove growths in the uterus, such as fibroids or polyps.
Your doctor may take a small sample of tissue (biopsy). The sample is looked at under a microscope for problems. Another surgery, called a laparoscopy, may also be done at the same time as a hysteroscopy if infertility is a problem.
Why It Is Done
A hysteroscopy may be done to:
- Find the cause of severe cramping or abnormal bleeding. Your doctor can pass heated tools through the hysteroscope to stop the bleeding.
- See whether a problem in the shape or size of the uterus or if scar tissue in the uterus is the cause of infertility.
- Look at the uterine openings to the fallopian tubes. If the tubes are blocked, your doctor may be able to open the tubes with special tools passed through the hysteroscope.
- Find the possible cause of repeated miscarriages. Other tests may also be done.
- Find and remove a misplaced intrauterine device (IUD).
- Find and remove small fibroids or polyps.
- Check for endometrial cancer.
- Use heated tools to remove problem areas in the lining of the uterus (endometrial ablation).
- Place a contraceptive implant (such as Essure) into the opening of the fallopian tubes as a method of permanent sterilization.
How To Prepare
Tell your doctor if you:
- Are or might be pregnant.
- Are taking any medicines.
- Are allergic to any medicines.
- Take a blood thinner, or if you have had bleeding problems.
- Have been treated for a vaginal, cervical, or pelvic infection in the past 6 weeks.
- Have any heart or lung problems.
It is best to have a hysteroscopy done when you are not having your menstrual period. If there is a chance that you could become pregnant, the hysteroscopy should be done before you are ovulating so your doctor is sure you are not pregnant.
Do not douche, use tampons, or use vaginal medicines for 24 hours before the hysteroscopy.
You may be given a medicine (sedative) to relax you for the test, or general, regional, or local anesthesia can be used. Your doctor will discuss this with you.
If you are going to have general anesthesia, you will need to stop eating and drinking before the test. Follow the instructions exactly about when to stop eating and drinking, or your surgery may be canceled. If your doctor has instructed you to take your medicines on the day of surgery, do so using only a sip of water.
Arrange to have someone drive you home the day of the test in case you are given a sedative.
You will be asked to sign a consent form that says you understand the risks of the test and agree to have it done.
Talk to your doctor about any concerns you have regarding the need for the test, its risks, how it will be done, or what the results will mean. To help you understand the importance of this test, fill out the medical test information form( What is a PDF document? ).
The hospital or surgery center may send you instructions on how to get ready for your surgery, or a nurse may call you with instructions before your surgery.
How It Is Done
A hysteroscopy is usually done by your gynecologist in the operating room of a hospital or surgery center. Most women go home the same day. In some cases, the hysteroscopy can be done in your doctor’s office.
You may be given medicine (anesthesia) to help you relax, to numb the area, or to help you sleep.
You will take off all of your clothes and wear a gown for the test. You will empty your bladder before the test. You will then lie on your back on an examination table with your feet raised and supported by footrests (stirrups).
Your doctor will insert a lubricated tool called a speculum into your vagina. The speculum gently spreads apart the vaginal walls so your doctor can see inside the vagina and the cervix. Your vagina will be cleaned with a special soap.
The hysteroscope will be placed at the entrance to your vagina and gently moved through the cervix into your uterus. A gas or liquid will be put through the hysteroscope into your uterus to help your doctor see the lining clearly. Your doctor looks through the hysteroscope at a magnified view of the lining of your uterus. Your doctor can also see the uterine openings of the fallopian tubes. A video screen may be used during the test.
If a biopsy or other procedure is done, your doctor will use small tools through the hysteroscope. A hysteroscopy takes about 30 minutes, unless other procedures are being done.
How It Feels
If you are given a sedative or a local or regional anesthesia, you may have some cramping during the test. If you have general anesthesia, you may have a tickling, dry throat, slight hoarseness, or a mild sore throat after the test; these symptoms may last several days. Throat lozenges and warm saltwater gargles can help relieve the throat symptoms.
Some women feel dizzy and sick to their stomachs. This is called a vasovagal reaction. This feeling will go away after a few minutes.
You may need to avoid sexual intercourse, using tampons, or playing sports for a while after hysteroscopy. Talk to your doctor about when you can resume normal activities.
Risks
If a fluid is used during the test to help your doctor see the uterine lining clearly, you may absorb some fluid and feel bloated. It may also change the level of sodium in your blood. If gas is used, you have a small risk for an air bubble (air embolism) in a blood vessel, though this is very rare.
A hysteroscopy can cause injury to the uterus or cervix, an infection, or bleeding. In rare cases, the uterus, bladder, or bowel can be punctured during the test, requiring surgical repair. If general anesthesia is used, there is a small risk of problems from the anesthesia.
After the test
Right after the test, you will be taken to a recovery area where nurses will care for and observe you. Usually you will stay in the recovery area for 1 to 4 hours, and then you will be moved to a hospital room or you will go home. In addition to any special instructions from your doctor, your nurse will explain information to help you in your recovery. You will likely go home with a sheet of care instructions and who to call if you have any problems.
It is normal to have a small amount of vaginal bleeding for a day or so after a hysteroscopy. You also may have some mild belly pain if a gas was used during the test. This should go away in 24 hours. Ask your doctor if you can take acetaminophen (such as Tylenol) to relieve the pain. Be safe with medicines. Read and follow all instructions on the label.
Follow any instructions your doctor gave you. Call your doctor if you have:
- Heavy vaginal bleeding or discharge (more than a normal menstrual period).
- A fever.
- Severe belly or pelvic pain or cramping.
- Problems urinating.
- Shortness of breath.
- Vomiting.
Results
A hysteroscopy is a way for your doctor to look at the lining of your uterus. He or she uses a thin viewing tool called a hysteroscope. Your doctor will talk to you about what he or she sees at the time of the hysteroscopy.
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Normal: |
The inside of the uterus looks normal in size and shape. |
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Openings to the fallopian tubes look normal. |
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Abnormal: |
The size or shape of the inside of the uterus does not look normal. |
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Scar tissue is present in the uterus. |
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Uterine polyps, fibroids, or other growths are present. |
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A misplaced intrauterine device (IUD) is found and removed. |
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The uterine openings to one or both fallopian tubes are closed. |
What Affects the Test
Reasons you may not be able to have the hysteroscopy or why the results may not be helpful include:
- Having your menstrual period. Your doctor will not be able to see the lining clearly.
- Being pregnant. A hysteroscopy will not be done if you are pregnant because of the risk to your developing baby (fetus).
- If a vaginal or cervical infection is present.
If you are not sexually active, a hysteroscopy can be done anytime. But it is best to have a hysteroscopy when you are not having your menstrual period.
If you are past menopause, a hysteroscopy can be done anytime.
What To Think About
- Removing uterine fibroids during a hysteroscopy may be possible instead of performing a hysterectomy in some women with abnormal bleeding.
- A hysteroscopy is not recommended for women with cervical cancer or pelvic inflammatory infection.
Credits
Current as ofFebruary 19, 2019
Author: Healthwise Staff
Medical Review: Sarah A. Marshall, MD – Family Medicine
Adam Husney, MD – Family Medicine
Martin J. Gabica, MD – Family Medicine
E. Gregory Thompson, MD – Internal Medicine
Kathleen Romito, MD – Family Medicine
Femi Olatunbosun, MB, FRCSC, FACOG – Obstetrics and Gynecology, Reproductive Endocrinology
Current as of: February 19, 2019
Author: Healthwise Staff
Medical Review:Sarah A. Marshall, MD – Family Medicine & Adam Husney, MD – Family Medicine & Martin J. Gabica, MD – Family Medicine & E. Gregory Thompson, MD – Internal Medicine & Kathleen Romito, MD – Family Medicine & Femi Olatunbosun, MB, FRCSC, FACOG – Obstetrics and Gynecology, Reproductive Endocrinology
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