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McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
Illustration
Diagnostic Hysteroscopy for Infertility
What is a diagnostic hysteroscopy?
A diagnostic hysteroscopy is a procedure in which the doctor
uses a hysteroscope to look at the inside of your uterus. A
hysteroscope is a thin tube with a tiny camera. The uterus
is the muscular organ at the top of the vagina. Babies
develop in the uterus, and menstrual blood comes from the
uterus.
When is it used?
Hysteroscopy may be done when you are having trouble getting
pregnant. It can help the doctor look for a defect in the
size or shape of the uterus, such as a double uterus or a
septate uterus. In a septate uterus, a thin band of tissue
separates the uterus into two compartments.
Examples of alternatives to this procedure are:
- having a D&C (dilation and curettage), in which the
doctor opens the cervix and scrapes or suctions tissue
from the uterus
- choosing not to have treatment.
You should ask your doctor about these choices.
How do I prepare for a diagnostic hysteroscopy?
Plan for your care and recovery after the procedure,
especially if you are to have general anesthesia. Allow for
time to rest and try to find other people to help you with
your day-to-day duties.
Follow instructions provided by your doctor. No special
preparation is needed for local or regional anesthesia. If
you are to have general anesthesia, eat a light meal, such
as soup or salad, the night before the procedure. Do not
eat or drink anything after midnight or the morning before
the procedure. Do not even drink coffee, tea, or water.
What happens during the procedure?
Hysteroscopy may be done in a doctor's office or in an
operating room.
You are given a local, regional, or general anesthetic. A
local or regional anesthetic numbs part of your body while
you remain awake. It should keep you from feeling pain
during the procedure. A general anesthetic relaxes your
muscles, puts you to sleep, and prevents you from feeling
pain.
The doctor dilates (opens) your cervix. The doctor guides
the hysteroscope through the cervix into the uterus. The
uterus is then inflated with fluid or gas. (This allows the
doctor to look at the inside of your uterus more closely.)
What happens after the procedure?
You may stay at your doctor's office or the hospital about 1
or 2 hours.
After the procedure you may:
- feel sleepy or groggy from the anesthetic
- have some cramps
- have trouble urinating the first few hours after the
procedure
- have a watery or bloody discharge for 3 or 4 weeks.
Ask your doctor what steps you should take and when you
should come back for a checkup.
What are the benefits of this procedure?
The doctor sees the condition of your uterus and may be able
to find a reason for infertility.
What are the risks associated with this procedure?
- There are some risks when you have general anesthesia.
Discuss these risks with your doctor.
- A local or regional anesthetic may not numb the area
quite enough and you may feel some minor discomfort.
Also, in rare cases, you may have an allergic reaction to
the drug used in this type of anesthesia. In most cases,
local or regional anesthesia is considered safer than
general anesthesia.
- Some blood vessels in the lining of the uterus may leak.
- You may have infection and bleeding.
- Rarely, the uterus could be punctured and need surgery to
repair it.
- Rarely, the bowel or bladder may be injured.
In general, the procedure poses little risk for most women.
You should ask your doctor how these risks apply to you.
When should I call the doctor?
Call the doctor immediately if:
- You start to bleed a lot (like a menstrual period).
- You develop a fever.
- You have a lot of pain in your lower abdomen.
Call the doctor during office hours if:
- You have questions about the procedure or its result.
- You want to make another appointment.
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