Hysteroscopy involves looking into the cavity of the uterus with a small “scope.” Hysteroscopy can be performed as either an office procedure or an outpatient hospital procedure.
In the office it is mainly used as a diagnostic tool to help evaluate patients that have infertility, recurrent miscarriage, or abnormal bleeding.
Office hysteroscopy is a relatively painless procedure. Usually an appointment will be made in advance for this procedure. Upon arrival you will be given a mild pain medicine to help with cramping during the procedure. Next, a local anesthetic, like dentists use (lidocaine), will be placed in the cervix. This usually provides excellent relief of any discomfort during the procedure. Usually carbon dioxide gas or water is attached to the scope to allow the walls of the uterus to expand.
The doctor will then carefully look at the inside of the uterus and make sure it is normal. The places where the fallopian tubes enter into the uterus can usually be seen. Any abnormalities are usually discussed afterward. In most cases, a small sample of the lining of the uterus is removed for examination. This is especially true if there is any abnormal bleeding.
If you are an infertility patient or a patient that has had multiple miscarriages, a common finding is a “septum” in the middle of the uterus. Other findings can include uterine fibroids and polyps, a commonly cause of abnormal bleeding. Sometimes cancerous or precancerous growths are found. Sometimes there are no abnormal findings, but even this information can be very useful and reassuring.
Most patients do not have any problems and can even go back to work the same day. Some patients may feel weak and have cramps that last several hours afterward. It is suggested that someone come with you that can drive you home afterward if you normally get a lot of cramps with your periods.
Serious risks are very rare but can include:
Common symptoms include unilateral leg (calf) swelling and pain. There may be tenderness to the calf extending up the thigh, into the groin.
You should call the doctor is you develop:
Some fibroids can be removed by passing a “wire loop electrode” through a operative hysteroscope. The loop is used to shave away the fibroid and the pieces removed from the uterus. Only fibroids that extend into the cavity of the uterus can be removed with this technique.
Polyps are extra growths of tissue from the lining of the uterus. They are usually benign, however can cause excessive bleeding. They are usually easy to remove through the operative hysteroscope as an outpatient.