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What is hysteroscopy?

Hysteroscopy is an exploratory procedure used to diagnose and treat abnormal bleeding in the uterus using a flexible, lighted tube called a hysteroscope. Hysteroscopy is used for both diagnostic and therapeutic purposes. The device is inserted through the vagina, which offers easy visual access to the interior of the cervix and uterus to evaluate the lining of these structures.

Therapeutic maneuvers, such as a tissue sample (biopsy), elimination of polyps or tumors, or preventing bleeding through cauterizing (demolition of tissue by electric current, freezing, heat, or chemicals) may be performed during a hysteroscopy procedure.

Hysteroscopy can also help your doctor determine causes of infertility. Learn more about the use of hysteroscopy to diagnose and treat infertility at the Northwell Health Fertility.

Treatment types

There are two uses for hysteroscopy:

  • Diagnostic—Diagnostic hysteroscopy can be completed in a physician's office or in an outpatient facility with or without local anesthesia. More aggressive therapeutic hysteroscopy procedures may be performed in an operating room under local, regional, or general anesthesia. Because your doctor can see the interior of the cervix and uterus during the operation, diagnostic hysteroscopy has become a more prevalent and widely used procedure than dilation and curettage (D&C), which is performed without endoscopic visualization. Hysteroscopy can be used to help diagnose an irregular Pap test, dysfunctional uterine bleeding or post-menopausal bleeding, and reasons for infertility or recurring miscarriages. It can also be used to evaluate uterine adhesions (Asherman's syndrome), polyps, and fibroids, and to detect and remove shifted intrauterine devices (IUDs).
  • Therapeutic—Therapeutically, hysteroscopy can be used to help fix uterine problems. For example, slight adhesions and fibroids can be removed through a hysteroscope. This elevates the need for more invasive, open abdominal surgery. Endometrial biopsy or ablation (removal of the endometrial lining) can be performed using a hysteroscopy. These procedures are sometimes called operative hysteroscopies.

Risks

Risks and side effects of an operative hysteroscopy could include:

  • Infection
  • Bleeding
  • Tearing of uterus or damage to the cervix (rarely)
  • Slight vaginal bleeding
  • Cramps after procedure
  • Water discharge 

How to prepare

Before your procedure, your doctor may administer nonsteroidal anti-inflammatory drugs such as Motrin to reduce any potential discomfort.

What to expect after treatment

After a hysteroscopy, you can expect light bleeding, potential discharge and cramping. Our specialists will follow up with you after your procedure to guarantee improvement and comfort.

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