What is a hysteroscopy?
Hysteroscopy is the visual examination of the canal of the cervix and interior of the uterus using a thin, lighted, flexible tube called a hysteroscope. The device is inserted through the vagina.
Hysteroscopy may be used for both diagnostic and therapeutic purposes. The hysteroscope allows for easy visual access to the interior of the cervix and uterus to assess the lining of these structures. Therapeutic maneuvers, such as taking a tissue sample (biopsy), removal of polyps or fibroid tumors, or preventing bleeding with cautery (destruction of tissue by electric current, freezing, heat, or chemicals) may be performed during a hysteroscopy procedure.
Diagnostic hysteroscopy may be performed in a physician's office or in an outpatient facility with local or no anesthesia required. More invasive therapeutic hysteroscopy procedures may be performed in the operating room under local, regional, or general anesthesia.
Because the physician is able to see the interior of the cervix and uterus during the procedure, diagnostic hysteroscopy has become a more common procedure than dilation and curettage (D & C), which is performed without endoscopic visualization.
Other related procedures that may be used to evaluate problems of the female pelvic organs include D & C, cervical biopsy, colposcopy, endometrial biopsy, laparoscopy, Pap test, and pelvic ultrasound. Please see these procedures for additional information.
What are female pelvic organs?
The organs and structures of the female pelvis are:
Endometrium—the lining of the uterus
Uterus—also called the womb, the uterus is a hollow, pear-shaped organ located in a woman's lower abdomen, between the bladder and the rectum. The uterus sheds its lining each month during menstruation, unless a fertilized egg (ovum) becomes implanted and pregnancy follows.
Ovaries—two female reproductive organs located in the pelvis in which egg cells (ova) develop and are stored, and where the female sex hormones estrogen and progesterone are produced
Cervix—the lower, narrow part of the uterus located between the bladder and the rectum, forming a canal that opens into the vagina, which leads to the outside of the body
Vagina—the passageway through which fluid passes out of the body during menstrual periods. Also called the "birth canal," the vagina connects the cervix and the vulva (the external genitalia).
Vulva—the external portion of the female genital organs
Reasons for the Procedure
Hysteroscopy may be performed in women who have an abnormal Pap test, abnormal uterine bleeding, or postmenopausal bleeding. It may be used to help diagnose causes of infertility or repeated miscarriages. Hysteroscopy may also be used to evaluate uterine adhesions (Asherman's syndrome), polyps, and fibroids, and to locate and remove displaced intrauterine devices (IUDs). Hysteroscopy is also used to place small inserts in the fallopian tubes that are a permanent method of birth control.
Therapeutically, hysteroscopy may be used to help correct uterine problems. For example, small adhesions, polyps, or fibroids may be removed through the hysteroscope, often eliminating the need for open abdominal surgery. Endometrial biopsy or ablation (removal of the endometrial lining) may be performed via hysteroscopy. The term "operative hysteroscopy" may be used in these situations.
Hysteroscopy cannot be performed during pregnancy.
There may be other reasons for your physician to recommend a hysteroscopy.
Risks of the Procedure
As with any surgical procedure, complications may occur. Some possible complications of hysteroscopy may include, but are not limited to, the following:
Pelvic inflammatory disease
Perforation of the uterus (rare)/damage to cervix
Complications from fluid or gas used to expand the uterus
You may experience slight vaginal bleeding and cramps for a day or two after the procedure.
There may be other risks depending upon your specific medical condition. Be sure to discuss any concerns with your physician prior to the procedure.