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Hysteroscopy is a diagnostic and surgical procedure that makes examination of the inside of the uterus possible without an abdominal incision. During hysteroscopy, a lighted viewing instrument (hysteroscope) is inserted through the vagina and cervix and into the uterus. Treatment can also be done through the hysteroscope during the same procedure.

Hysteroscopy usually takes 30 to 45 minutes and is done as an outpatient procedure. General anesthesia is usually used, although local or spinal anesthesia can be used instead. You should not eat or drink for at least 8 hours before having the test. A gynecologist or surgeon performs the procedure.

The uterus is filled with a fluid, such as normal saline or glycine. The hysteroscope is inserted through the cervix into the uterus so the inner surface of the uterus can be examined. Hysteroscopy locates the cause of bleeding for many women.

Why It Is Done

Hysteroscopy is used to both diagnose and treat abnormal vaginal bleeding. If areas of bleeding are found during the procedure, the tissue may be destroyed by laser beam or electric current (electrocautery) or surgically removed at the same time.

Hysteroscopy is done to:
  • Locate and evaluate the cause of uterine bleeding, such as uterine fibroids, when blood loss is severe.
  • Confirm a diagnosis before starting treatment with medications that have significant side effects, such as danazol or GnRH-As.
Results of hysteroscopy may include the following.
  • Normal
  • Abnormal
  • Abnormal tissue growths, uterine fibroids, areas of active bleeding, or scar tissue is found in the uterus. Hysteroscopy provides an accurate diagnosis of fibroids or other abnormal conditions within the uterine cavity.
What To Think About

Hysteroscopy may be used to determine the cause of undiagnosed uterine bleeding before starting treatment with medications or surgery. It is important to find the cause of the bleeding before starting treatment with medications that have significant side effects, such as danazol or GnRH-As.

A hysteroscopy may be used to both diagnose and treat fibroids, which can cause heavy vaginal bleeding.

Hysteroscopy improves the outcome of surgery to remove fibroids (myomectomy).

Complications occur in 3% to 6% of women and can include:
  • Too much fluid absorbed in the blood (fluid overload).
  • Low blood levels of sodium (hyponatremia).
  • Fluid collection in the brain (cerebral edema) or the lungs (pulmonary edema).
  • Injury to the lining of the uterus.
  • Puncture of the uterus (uterine perforation) and bleeding (hemorrhage).
The safe and effective use of a hysteroscope requires specialized training by the doctor.

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