Hysteroscopy is a procedure used to diagnose and treat uterine problems using a special instrument called a hysteroscope. A hysteroscope is a thin telescope attached to a camera that is inserted into the vagina, through the cervix and inside of the uterus. Typically a saline solution will be put through the hysteroscope into your uterus to expand it to enable your doctor to evaluate the uterine cavity.
This is an outpatient procedure that can be performed either in your specialist’s office or in the hospital. It is sometimes done under local anesthesia and other times with sedation. It is often done as a follow-up if an abnormality was found in the uterine cavity by HSG or SHG.
What it Diagnoses:
The most common issue that a hysteroscopy is used to diagnose is abnormal bleeding. Abnormal bleeding can refer to heavy, elongated, short or infrequent menstrual cycles, as well as bleeding in between cycles. Additionally, a hysteroscopy can be used to help diagnose the cause of recurrent miscarriage. The most common findings include polyps, fibroids and adhesions (scar tissue).
What it can Treat:
Inserted through the hysteroscope, surgical instruments can be used to remove adhesions, polyps, fibroids, as well as perform a biopsy.
When to schedule your appointment:
This test must be done after you stop bleeding but before you ovulate (typically cycle days 5-9). Your doctor may dilate your cervix prior to the procedure. If you are a mikvah user (link to Infertility and Halacha), it is helpful to schedule this appointment as close to the last day of your period.
Bring along with you:
- Come prepared with a pad or panty liner, there will be discharge and this procedure could cause some light bleeding.
- Many people experience cramping from this procedure. Confirm with your Doctor prior to the visit what type of pain relief medication you are allowed to take. With your doctor’s permission, in order to stay ahead of the pain, take the pain relievers 45 minutes prior to the procedure.
A few more things to keep in mind:
- Complications from hysteroscopy occur in about 2 of every 100 cases.
- Risks include bleeding, infection and damage to the uterus or surrounding organs, nerves and blood vessels. Severe complications are very rare.
- To prevent infection you may be asked to take estrogen or antibiotics following the hysteroscopy.
Step 3: Make a checklist of next steps:
Empower yourself. Take note of what you can and cannot control, focus on the items that are within your control. For example, a medical condition which causes infertility is not in your power, but focusing on making appointments and seeking out specialists is.
Always remember that you are your own best advocate. You are a partner in this process. It is ok to stand up for yourself and your needs. Do not be afraid to ask questions or to seek second opinions.