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 abnormal bleeding. Your
doctor can pass heated tools through the hysteroscope to stop the
bleeding.
- Find the cause of bleeding after
menopause.
- 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 reposition a misplaced
intrauterine device (IUD).
- Find and remove
small fibroids or polyps.
- Use heated tools to remove problem areas
in the lining of the uterus (endometrial ablation).
- Place a contraceptive implant (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.
- Have had bleeding problems or take blood-thinners, such
as aspirin or warfarin (Coumadin).
- 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 not be able to eat or
drink for 8 hours before the test.
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 before the test. 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 to help you relax, to numb the area, or
to help you sleep (local, regional, or general anesthesia).
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 put an instrument with smooth, curved blades
(speculum) into your vagina. The speculum gently spreads apart the vaginal
walls so your doctor can see inside the vagina and the cervix. See a picture of
a pelvic examination with a speculum. 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
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. You can take
acetaminophen (such as Tylenol) to relieve the pain.
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.
Hysteroscopy| Normal: | The inside of the uterus looks normal in size and shape.
|
|---|
No
polyps,
fibroids, or other growths are present. |
Openings to the
fallopian tubes look normal. |
| Abnormal: | The size or shape of the inside of the uterus does not look
normal. |
|---|
Scar tissue is present in the uterus and may be the cause of
infertility. |
Uterine polyps, fibroids, or other growths are
present. |
A misplaced
intrauterine device (IUD) is found and
repositioned. |
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.
References
Other Works Consulted
- Chernecky CC, Berger BJ, eds. (2004). Laboratory Tests and Diagnostic Procedures, 4th ed.
Philadelphia: Saunders.
- Pagana KD, Pagana TJ (2006). Mosby’s Manual of Diagnostic and Laboratory Tests, 3rd ed. St. Louis:
Mosby.
Credits
| Author | Maria G. Essig, MS, ELS |
| Editor | Susan Van Houten, RN, BSN, MBA |
| Associate Editor | Tracy Landauer |
| Primary Medical Reviewer | Kathleen Romito, MD - Family Medicine |
| Specialist Medical Reviewer | Liisa Honey, MD, FRCSC - Obstetrics and Gynecology |
| Last Updated | February 22, 2008 |