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-thereatening 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.