Hysteroscopy

What is it?

iStock 000011860992SmallA hysteroscope is a slender telescopic instrument that is used to let the physician look inside your uterus. The procedure of placing this instrument into your uterus is called hysteroscopy. It is considered minor surgery and can be performed in the doctor's office procedure room or in a hospital operating room. Over 95% of our hysteroscopies we do here in our procedure room.

Why is it ordered?

Hysteroscopy is used to assess the size and shape of the endometrial cavity, look for and remove polyps, take a targeted biopsy to rule out conditions such as endometrial hyperplasia (precancer), chronic endometritis (low grade intra-uterine infection), and cancer. Occasionally used to remove fibroids, septums, and foreign bodies such as IUDs.

What about anesthesia?

We look after your comfort every step of the way. Most of our patients do not experience any significant discomfort or remember much about the procedure. That's because we do these procedures with IV conscious sedation. IV sedation is performed by a licensed CRNA who is contracted with us or by one of our RNs under physician supervision.

Please see our separate IV Conscious Sedation instructions. To summarize, we ask you to have nothing by mouth for 6-8 hours prior to the procedure, not even water or gum, and to be sure you have someone to drive you home after the procedure. Please arrive 30 minutes prior to your scheduled procedure to allow time to start your IV. Also allow approximately 20-30 minutes to wake up after the conscious sedation.

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What happens during my procedure?

The actual procedure takes approximately 10-15 minutes.

A medication, called Misoprostol (Cytotec) will be prescribed to the night before to take with food. It helps soften the cervix and may cause mild cramping. If it does, please take Tylenol rather than Ibuprofen for the cramps. (Ibuprofen reverses the effect).

Usually the cervix does not need to be dilated if you used Cytotec, but occasionally it may need to be dilated, or made wider, with special instruments. The hysteroscope is inserted and a liquid (sterile saline) is released through the hysteroscope to expand the uterus making it easier for the physician to see. If additional procedures are to be done, such as removing a polyp, small instruments are inserted through the hysteroscope.

What are the risks and complications?

Hysteroscopy is a relatively safe procedure. In less then 1% of cases injury to cervix or the uterus, infection, heavy bleeding or side effects of the anesthesia occur.

What can I expect after my procedure?

 If the procedure was done in the office under local anesthesia or local sedation, you will be able to go home when the physician deems appropriate and when you meet specified discharge criteria (typically within 30 minutes or so). You should be sure you have someone to drive you home and stay with you for 6 hours.

For a day or two after, you may have vaginal bleeding and cramps. This is fairly normal. However, in the rare event that you experience fever, severe abdominal pain or heavy vaginal bleeding or discharge, you should notify our office right away.

Please refrain from making any important personal or financial decisions for 24 hours after oral or IV sedation because it can mildly affect judgment and reasoning for that period of time. Also refrain from operating vehicles or from consuming alcohol.

Unless otherwise arranged with your provider, we usually set up an appointment to review your results 2-3 weeks later and plan any further necessary management. You will also receive a phone call the day after from our staff to see how you are doing and a notification of the pathology (if normal) from our office once it has been reviewed.