McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
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What is a hysteroscopy?

A 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. If you have a septum in your uterus, your doctor can guide a tool into the uterus to remove the septum. A septum is a tissue that divides the uterus.

When is it used?

This procedure is performed to remove a septum in your uterus. The septum may be preventing you from successfully carrying a pregnancy.

Examples of alternatives to this procedure are:

• having abdominal surgery to remove the septum
• choosing not to have treatment, recognizing the risks of your condition.

You should ask your doctor about these choices.

How do I prepare for a therapeutic 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 uses a laser or a tool called an electrocautery resectoscope to remove the septum.

What happens after the procedure?

You may stay at the 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?

Removing the septum improves your ability to carry a pregnancy successfully. This method avoids the discomfort, hospitalization, expense, and longer recovery associated with abdominal surgery.

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.

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.

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.