Hysteroscopy: Procedure and Recovery

There are many reasons your gynecologist might want to get a better look at the inside of your uterus – whether that’s to determine the cause of unusual bleeding, treat adhesions, or see why you’re having trouble conceiving. What happens in a hysteroscopy? Let’s go through the process so you can be prepared.

What is a hysteroscopy?

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Hysteroscopy is a procedure to examine the uterus, take a biopsy, diagnose conditions, and sometimes provide treatment. It uses a hysteroscope – a long, thin tube 3 to 5 mm in diameter with a light and camera – to access the uterus through the vagina and display the images on a screen. (If you’ve ever had an endoscopy done, this is a similar procedure.)

What is a hysteroscopy used for?

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Hysteroscopy is a relatively non-invasive way for your doctors to examine the inside of the uterus. This allows doctors to see what’s causing irregular bleeding (bleeding between periods). Hysteroscopy can also be used to diagnose the cause of repeated miscarriages.

Tiny instruments attached to the end of the hysteroscope can also be used to perform minor surgical procedures such as:

  • Removing adhesions (scar tissue bands) from previous surgeries or conditions like Asherman’s syndrome
  • Removing polyps and fibroids
  • Endometrial ablation (destroying a section of uterine lining to treat heavy bleeding)
  • Opening up the fallopian tubes
  • Taking an endometrial biopsy

Getting ready for a hysteroscopy

Hysteroscopy is a common and quite straightforward procedure. You may be given local anesthesia, so you won’t feel any pain while the hysteroscopy is happening.

However, if you’re having a little more complicated work done, like removing fibroids, it may be done using a general anesthetic. If your hysteroscopy involves a general anesthetic, your doctor will give you more detailed instructions, such as fasting before the procedure.

To get a good look at the inside of your uterus, a hysteroscopy has to be conducted at a particular point in your menstrual cycle when the endometrium uterine lining is thin. This usually should be right after your last period. If your periods are hard to predict, or you’re not able to get to an appointment at this time, your doctor may prescribe you contraceptive pills to keep the endometrium from building up.

Hysteroscopy procedure: What happens?

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The whole process of a hysteroscopy should be about 30 minutes and usually goes like this:

Step 1: You’ll be asked to lie down on a couch. A speculum may also be used to keep the vagina open.

Step 2: The vagina and cervix are cleaned with an antiseptic, and the hysteroscope is inserted through the cervix.

Step 3: Gas or fluid is pumped into the uterus to improve visibility.

Step 4: The hysteroscope transmits images from inside of the uterus to a screen for your doctor to see.

Step 5: Go home.

Hysteroscopy recovery: How long does it take?

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Recovery time after a hysteroscopy is usually very quick. However, you might want to take it easy for the next day or so: a hysteroscopy can cause some period-like cramping and bleeding after the procedure, and if you’ve had a general anesthetic, it might take a little while to bounce back. Also, you should wait a week before having sex.

If you experience symptoms such as heavy bleeding, fever or severe abdominal pain after a hysteroscopy, get to a doctor right away.

Don’t get too worried about a hysteroscopy

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Hysteroscopy might sound like an intimidating procedure at first. “How do you even fit a camera through a cervix?!” is not a surprising reaction. But fear not: hysteroscopy is a simple and common procedure. Your doctor will be able to examine and possibly treat a number of uterine problems that contribute to infertility. In most cases, you should be back on your feet in no time.