Hysteroscopy

Hysteroscopy is a surgical procedure to evaluate women with infertility, recurrent miscarriage, or abnormal uterine bleeding. Diagnostic hysteroscopy is used to examine the uterine cavity and is helpful in diagnosing abnormal uterine conditions such as internal fibroids, scarring, polyps, and congenital malformations.

The diagnostic hysteroscopy usually involves slightly stretching the canal of the cervix with a series of dilators to temporarily increase the size of the opening of the cervix. Once the cervix is dilated, the hysteroscope (a long, thin, lighted, telescope-like instrument) is inserted through the cervix and into the uterus. Skin incisions are not required for hysteroscopy. Carbon dioxide gas or special fluids are then injected into the uterus through the hysteroscope. This gas or fluid expands the uterine cavity and enables the physician to directly view the internal structure of the uterus.

Diagnostic hysteroscopy is an outpatient procedure performed under general anesthesia.

Complications of hysteroscopy occur in about two out of every 100 procedures. Perforation of the uterus (a small hole in the uterus) is the most common complication. Although perforations usually close spontaneously, they may cause bleeding or damage to nearby organs, which may necessitate further surgery. Uterine adhesions or infections may develop after hysteroscopy. Serious complications related to the fluids used to distend the uterus include fluid in the lungs, blood clotting problems, fluid overload, electrolyte imbalance, and severe allergic reactions. Severe or life-threatening complications, however, are very uncommon. Some of the complications above may prevent completion of the surgery.

Following hysteroscopy, some vaginal discharge or bleeding and cramping may be experienced for several days. Most physical activities can usually be resumed within one or two days.

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