Hysteroscopy

Pre- and Post-Operative Instructions

Therapeutic Hysteroscopy is a procedure performed to evaluate and treat the internal architecture of the uterine cavity through direct visual inspection and manipulation. The hysterocope used is of sufficient diameter, that the procedure requires some type of anesthesia. The best way to perform this procedure is with a light general anesthetic which is given intravenously, typically either by an anesthesiologist or nurse anesthetist working with an anesthesiologist. Patients are in a light sleep during the procedure. Postoperative nausea is generally mild if it occurs at all.


This procedure is best performed when the uterine lining (endometrium) is thin (thickened endometrium makes it difficult to see). Usually, this means early in the menstrual cycle, just after bleeding has stopped, but prior to expected ovulation. If scheduling does not allow us to perform the procedure at this ideal time, we may recommend that you take the oral contraceptive pill beginning on day 3 of your cycle and stay on it until the time of the procedure.


The Procedure:

We are currently using an 5.5-9.5 mm rigid scope for performing the procedure. Larger scopes allow us to pass operative instruments such as grasping forceps, scissors, or elecrosurgical instrumentation through the scope to allow therapeutic treatment of lesions that we encounter. A speculum is placed, and the vagina and cervix are cleansed with an antibacterial solution. The scope is then guided through the cervix, and the uterus visualized. An electrolyte solution is used to distend the uterine cavity to allow visualization. The procedure typically lasts 15-30 minutes.


Side Effects/Complications:

In most cases patients experience uterine cramping similar to menstrual cramps. Also some vaginal bleeding is not uncommon, and may last for a week or so. Complications may include uterine bleeding, perforation, and/or infection. These injuries are infrequent, but not rare in therapeutic procedures. Nausea occurs postoperatively in some cases.


After the Procedure:

You should have someone drive you home. You may experience light vaginal bleeding and cramping for a few hours after the procedure. Spotting may last a few days. If you experience heavy bleeding, fever greater than 100.4 degrees F, foul smelling vaginal discharge, chills or severe and persistent abdominal pain, notify the office immediately. We want to make sure that you have not experienced a surgical complication such as uterine perforation or infection. These complications are rare (< 1%), but potentially serious.