• What is hysteroscopy?

    Hysteroscopy is a procedure that allows your doctor to look inside your uterus in order to find the cause of failed implantation of embryos, failed IVF cycles or recurrent miscarriages and also to diagnose and treat causes of abnormal bleeding in certain patients. Hysteroscopy is done using a thin, lighted tube (hysteroscope), 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) or hycosy. HSG and hycosy is an X-ray dye & ultrasound dye test respectively that is used to check the uterus and fallopian tubes. Diagnostic hysteroscopy can be done in an out-patient setting as well as in operation theatre. Additionally, hysteroscopy can be used with other procedures, such as dilatation & curettage (D&C) or before starting IVF for dilation of cervix in case of previous cervical surgery or difficult embryo transfer.

  • What is operative hysteroscopy?

    Operative hysteroscopy is used to correct an abnormal condition that has been detected during a diagnostic hysteroscopy or during ultrasound examination. 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:

    This includes:
    • 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.
  • What are the benefits of hysteroscopy?

    Compared with other more invasive procedures, hysteroscopy may provide the following advantages:

    This includes:
    • Shorter hospital stay
    • Shorter recovery time
    • Less pain medication needed after surgery
    • Avoidance of hysterectomy which is used in women for abnormal bleeding near menopuase
    • 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
    • Infection
    • Heavy bleeding
    • Injury to the cervix, uterus, bowel or bladder
    • Intrauterine scarring
    • Reaction to the substance used to expand the uterus
  • When should the procedure be performed?

    Your doctor may recommend hysteroscopy for the first week after your menstrual period. This timing will provide the doctor with the best view of the inside of your uterus. Hysteroscopy is also performed to determine the cause of unexplained bleeding or spotting in pre and post-menopausal women.

  • What type of anesthesia is used for hysteroscopy?

    Anesthesia for hysteroscopy may be local, regional or general:

    • Local Anesthesia - The numbing of only a part of the body for a short time
    • Regional Anesthesia - The numbing of a larger portion of the body for a few hours
    • General Anesthesia - The numbing of the entire body for the entire time of the surgery
    • The type of anesthesia used is determined by where the hysteroscopy is to be performed (hospital theatre or clinic) and whether other procedures will be done at the same time. If you are having general anesthesia, you will be told not to eat or drink for a certain amount of time before the hysteroscopy

  • How is hysteroscopy performed?

    Prior to the procedure, your doctor may prescribe a sedative to help you relax. You will then be prepared for anesthesia. The procedure itself takes place in the following order:

    • The doctor will dilate (widen) your cervix to allow the hysteroscope to be inserted.
    • The hysteroscope is inserted through your vagina and cervix into the uterus.
    • Carbon dioxide gas or a liquid solution is then inserted into the uterus, through the hysteroscope, to expand it and to clear away any blood or mucus.
    • Next, a light shown through the hysteroscope allows your doctor to see your uterus and the openings of the fallopian tubes into the uterine cavity.
    • Finally, if surgery needs to be performed, small instruments are inserted into the uterus through the hysteroscope.

    The time it takes to perform hysteroscopy can range from less than 5 minutes to more than an hour. The length of the procedure depends on whether it is diagnostic or operative. In general, however, diagnostic hysteroscopy takes less time than operative.

  • What can I expect after the procedure?

    If regional or general anesthesia is used during your procedure, you may have to be observed for several hours before going home. After the procedure, you may have some cramping or slight vaginal bleeding for one to two days. In addition, you may feel shoulder pain if gas was used during your hysteroscopy. It is also not unusual to feel somewhat faint or sick. However, if you experience any of the following symptoms, be sure to contact your doctor:

    • Fever
    • Severe abdominal pain
    • Heavy vaginal bleeding or discharge
  • Will I have to stay in the hospital overnight?

    Hysteroscopy is considered minor surgery and usually does not require an overnight stay in the hospital. However, in certain circumstances, such as if your doctor is concerned about your reaction to anesthesia or any complications seen then an overnight stay may be required.

  • Who is a candidate for this procedure?

    Although there are many benefits associated with hysteroscopy, it may not be appropriate for some patients. A doctor who specializes in this procedure will explain it to you.

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