Hysteroscopy
www.bcwomens.ca
What is a hysteroscopy?
A hysteroscopy is a procedure in which
the doctor can look into your uterus (womb).
This is done by inserting a special narrow telescope
(hysteroscope) through the cervix (opening of the uterus)
into the uterus. The doctor uses the hysteroscope to
examine the cause of abnormal bleeding, to look for a lost
IUD, or to identify physical abnormalities within the uterus
that may interfere with pregnancy. A hysteroscopy can
also be sometimes used to treat a problem like removing
abnormal tissue (polyps or fibroids).
Pregnancy and hysteroscopy
It is important that you are not pregnant when the doctor
performs the hysteroscopy. If there is any chance you
may be pregnant, please let us know so that the
procedure can be cancelled or rescheduled at a more
appropriate time.
Booking your procedure
To ensure that you are not pregnant at the time of
hysteroscopy, the procedure is typically performed during
the first half of the menstrual cycle (prior to ovulation or
egg release from the ovary). It is also important that you
are not bleeding at the time of the procedure as this can
make it difficult for the doctor to see the inside of the
uterus well.
The hysteroscopy procedure usually takes about 15
minutes, but please allow yourself approximately 30-45
minutes in the clinic on this day.
Prepare for your procedure
The day of the procedure you may eat a light breakfast
or lunch. If you are having an IUD or polyp removed, you
will be asked to take a medication 1 hour prior to your
appointment to help with opening the cervix prior to the
procedure.
If you are feeling anxious about the procedure, the nurse
will review relaxation exercises with you and may offer
you a mild sedative (Ativan). If you do wish to use a
sedative, you must ensure that there is an adult to take
you home following the procedure; you cannot drive or
take public transit on your own following sedation.
There is often some mild period-like cramping during the
procedure; we recommend that you take acetaminophen
(Tylenol®) or ibuprofen (Advil®) 1 hour prior to the
procedure, and additional pain medication may be given
in the clinic if required.
What happens during the procedure?
The first part of the procedure is very much like a pap
smear that you would have with your family doctor: the
doctor will first place a speculum in the vagina to view the
cervix. The cervix is then rinsed with an antiseptic
(cleaning) solution. The hysteroscope is placed into the
opening of the cervix and then slowly advanced into the
uterus using sterile saline (salt-water) or carbon dioxide
gas to open the cervix and uterus and allow you to see
inside the uterus clearly. This commonly causes some mild
cramping.
Occasionally, the doctor may need to open (dilate) the
cervix slightly in order to insert the hysteroscope. To make
this more comfortable, the doctor may inject some local
anesthetic (freezing) into the cervix.
If you wish, you can see what the doctor is seeing through
the hysteroscope on a video monitor.
What can you expect after the
hysteroscopy?
You may have mild period-like cramps and a small amount
of vaginal bleeding. These cramps should be mild and
should be controlled with acetaminophen or ibuprofen. If
bleeding persists for more than one week, or cramping is
severe, please call the clinic. To reduce the chance of
infection, please do not use Tampons for 24 hours and do
not have intercourse until any bleeding has stopped.
Are there any risks?
Although hysteroscopy is very routine and safe, there is a
small risk of infection or uterine perforation with this
procedure (less than 1% chance). There are not usually
serious problems, but if you have severe or worsening
cramping, foul smelling vaginal discharge or fever in the
few days following your procedure please contact the
clinic as soon as possible.