McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
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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?

You may have a hysteroscopy to look for a lost IUD. An IUD is a small plastic device, sometimes with copper on it, that can be inserted in the uterus to prevent pregnancy. Sometimes the IUD moves out of its proper position inside the uterus. It can become embedded in the uterine wall or surrounding tissue and become lost.

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 a 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.) The doctor will look for the IUD and, if necessary, remove it.

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 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 may be able to find the IUD and remove it, if necessary.

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 or 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 the lower abdomen.

Call the doctor during office hours if:

• You have questions about the procedure or its result.
• You want to make another appointment.

This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.