How to Prepare for Your Hysteroscopy

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Hysteroscopy is a medical procedure that uses a narrow device with a light and camera on the end (hysteroscope) to take images of the inside of your uterus. This thin, telescope-like instrument is inserted into the uterus through the vagina and cervix. Your healthcare provider may just use the images to assess your health, or they may use it with other medical instruments to diagnose or treat a uterine problem.

Hysteroscopy is a minor procedure that is performed either in your healthcare provider’s office or in a hospital setting. It can be performed with local, regional, or general anesthesia—sometimes no anesthesia is needed. The risks of these procedures are low for most people.

This article explains why a hysteroscopy is done, what you need to do before the procedure, and what to expect during and after it.

What Happens During a Hysteroscopy
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Uses

Hysteroscopy may be either diagnostic or operative.

Diagnostic Hysteroscopy

Diagnostic hysteroscopy is used to evaluate and/ or diagnose certain conditions, and may also be used to confirm the results of other tests such as hysterosalpingography (HSG).

Diagnostic hysteroscopy can be used to diagnose certain conditions such as:

It can also be used to locate displaced intrauterine devices (IUDs).

Operative Hysteroscopy

An operative hysteroscopy may be used to both diagnose and treat certain conditions, such as uterine adhesions, septums, or fibroids, which, depending on the location, can sometimes be removed during a hysteroscopy.

Other instruments or techniques, such as a resectoscope, dilation and curettage (D&C), and laparoscopy, are sometimes used in conjunction with the hysteroscopy.

A hysteroscopy and laparoscopy may be used together to diagnose and treat conditions associated with infertility.

When Should It Be Performed?

A hysteroscopy should be scheduled for a week when you will not get your period. If you unexpectedly start to menstruate before your appointment, let your healthcare provider know right away. You may need to reschedule the procedure.

How to Prepare for a Hysteroscopy

If your hysteroscopy is being performed for a specific type of diagnostic procedure or treatment, your healthcare provider may need to prescribe medication before your scheduled hysteroscopy.

For instance, before a myomectomy, you may need to take Lupron Depot (leuprolide acetate) for about three months before the procedure to shrink the fibroids before they are removed.

What to Expect the Day Before Surgery

If you are having general anesthesia in the hospital, you will be told not to eat or drink anything for a certain period of time before the procedure (usually after midnight the night prior).

What to Expect the Day of Surgery

Routine lab tests may be ordered as well for women having a hysteroscopy in the hospital. You will be asked to empty your bladder and your vaginal area will be cleansed with an antiseptic.

You may be given a medication to help you relax, and you may be given one of the following types of anesthesia:

  • Local anesthesia: You will receive an injection of anesthetic around the cervix to numb it, with this type of anesthesia you remain awake and may feel some cramping.
  • Regional anesthesia: A drug is injected, through a needle or tube in your lower back that blocks the nerves that receive sensation from the pelvic region. You are awake with this type of anesthetic but feel no discomfort. Regional anesthesia is also called a spinal or epidural.
  • General anesthesia: You will not be conscious during your hysteroscopy when general anesthesia is used. A mask over your mouth and nose allows you to breathe a mixture of gases. Once you are under anesthesia, a tube may be inserted down your throat to help you breathe because general anesthesia interferes with natural breathing.

Your healthcare provider will determine which type of anesthesia is best for you based on the reason for your hysteroscopy. Do ask questions if anything about your procedure or anesthesia is unclear.

During the Procedure

The opening of your cervix may need to be dilated at the start of a hysteroscopy, or it may be made wider with special instruments.

  1. The hysteroscope is inserted through your vagina and cervix, and into your uterus.
  2. Next, a liquid or gas is usually released through the hysteroscope to expand your uterus so your healthcare provider will have a better view of the inside.
  3. A light source shone through the hysteroscope allows your healthcare provider to see the inside of the uterus and the openings of the fallopian tubes into the uterine cavity.
  4. If surgery is required, small instruments are inserted through the hysteroscope.

The procedure should not cause serious pain, but you may feel cramping or some discomfort.

How Long Does a Hysteroscopy Take?

Depending on what is done during the procedure, a hysteroscopy usually takes between 15 minutes and an hour.

After the Procedure

Patients who received a local anesthetic can usually go home soon after the procedure. Those who had regional or general anesthesia require a longer observation period before they are released, but can usually go home on the same day.

Some patients may experience shoulder pain following laparoscopy or when gas is used to expand the uterus. Once the gas is absorbed, the discomfort should subside quickly. You may continue to have some cramping along with light vaginal bleeding for a few days following the procedure. Over-the-counter medication should help with the discomfort.

When to Call Your Healthcare Provider

Contact your healthcare provider if you develop any of the following after your hysteroscopy:

How Long Should You Rest After a Hysteroscopy?

You may be ready to return to normal activities the day after your procedure. Some women report returning to work the same day following a hysteroscopy.

Discuss recovery with your healthcare provider, though. Every person is different and, depending on other procedures you may have undergone, you may need more time to rest.

What Should You Not Do After a Hysteroscopy?

While you may be ready to return to general activities soon after the procedure, it’s usually recommended that you do not have sexual intercourse for two weeks following the hysteroscopy.

 What Are the Risks of a Hysteroscopy? 

Hysteroscopy is a fairly safe procedure. As with all surgeries, there is a risk of infection or negative effects from the anesthesia. Other problems that can occur in rare cases include:

  • Puncturing of the cervix or uterus
  • Heavy bleeding
  • Fluid overload building up in your system

Summary

A hysteroscopy is a procedure that uses a narrow scope and a light to take images of the inside of your uterus. The scope is inserted through the vagina, so it does not require any surgical incisions.

This procedure is often used along with other instruments or diagnostic or operative tools to treat or diagnose certain diseases or disorders.

Since a hysteroscopy is minimally invasive, it often is done as a day surgery. Depending on other procedures that are done at the same time, you may be able to return to normal activities within a day.

10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Tracee Cornforth
Tracee Cornforth is a freelance writer who covers menstruation, menstrual disorders, and other women's health issues.