Hysteroscopy

Your doctor may recommend a hysteroscopy procedure to evaluate if you could have an abnormality within your uterus. The hysteroscope is a thin telescope-like instrument that is inserted through your vagina and cervix and then into your uterus.

This procedure provides the doctor with a way to view inside of your uterus and make a certain diagnosis. Sometimes, hysteroscopy is done in conjunction with a laparoscopy procedure (see below for discussion of laparoscopy).

The hysteroscopy procedure has many uses. When it comes to fertility evaluation, this procedure is often performed to evaluate a defect in the shape or size of the uterus. For example, if the patient has a septate uterus, the hysteroscopy may be able to diagnose this condition and also remove the membrane at the same time. The procedure may also be used to diagnose the presence of fibroids, polyps, or adhesions. These lesions might be missed during the HSG procedure (discussed previously); thus the hysteroscopy provides another way to detect uterine abnormalities. In some cases, these abnormalities can be surgically corrected during the same hysteroscopy procedure, if you are comfortable and under anesthesia.

Hysteroscopy may be performed in the doctor's office or in an operating room. For the procedure itself, your cervix will be dilated slightly to permit the hystero-scope to pass through. Then the thin hysteroscope will be inserted through your vagina and cervix and up inside of your uterus. A harmless liquid or gas may be passed through the hysteroscope to expand your uterus for optimal viewing. If surgery is required, small thin instruments are passed through the hysteroscope. You may experience some discomfort and cramping during the procedure. Depending on the situation, you and your doctor may decide that you will need anesthesia.

Hysteroscopy is considered a relatively safe procedure. There is a small chance of injury to the cervix or uterus, infection or bleeding, or side effects from anesthesia. However, overall these problems are quite rare.

After the hysteroscopy, you may feel some discomfort or cramping. You may also experience slight vaginal bleeding. Be sure to contact your doctor if you notice fever, severe abdominal pain, or heavy vaginal bleeding.

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