Hysteroscopy: Looking Inside the Uterus

By Yemi Adesanya-Famuyiwa, MD

Hysteroscopy is a way to look inside the uterus. A hysteroscope is a thin, telescope-like device that is inserted into the uterus through the vagina and cervix. It may help a doctor diagnose or treat a uterine problem.

Uses of Hysteroscopy

Hysteroscopy is minor surgery that may be done in a doctor’s office or operating room with local, regional or general anesthesia. In some cases, little or no anesthesia is needed. The procedure poses little risk for most women. Hysteroscopy may be used for diagnosis, treatment or both.

Diagnostic Hysteroscopy

Hysteroscopy can be used to diagnose some problems in the uterus. It also can be used to confirm the results of other tests, such as hysterosalpingography (HSG).

The hysteroscope is sometimes used with other instruments or
techniques. For instance, it may be done before dilation and curettage (D&C) or at the same time as laparoscopy. In a D&C, the cervix is widened (dilation) and part of the lining of the uterus is removed (curettage). In laparoscopy, a slender, telescope-like device is inserted into the abdomen through a tiny incision (cut) made through or just below the navel. Hysteroscopy also may be used for other conditions.

Operative Hysteroscopy

When hysteroscopy is used to diagnose certain conditions, it may be used to correct them as well. For instance, uterine adhesions or fibroids often can be removed through the hysteroscope. Sometimes hysteroscopy can be used instead of open abdominal surgery. Often it will be done in an operating room with general anesthesia.

The hysteroscope is used to perform endometrial ablation – a procedure in which the lining of the uterus is destroyed to treat some causes of heavy bleeding. After this is done, a woman can no longer have children. For this procedure, the hysteroscope is sometimes used with other instruments, such as a laser or a resectoscope. The resectoscope is a specially designed telescope with a wire loop or a rollerball at the end. Using electric current, any of these tips can be used to destroy the uterine lining. Endometrial ablation is done in an outpatient setting in most cases.

What To Expect

Hysteroscopy is a safe procedure. Problems such as injury to the cervix or the uterus, infection, heavy bleeding or side effects of the anesthesia occur in less than 1% of cases.