Diagnostic hysteroscopy is a simple office procedure that allows the physician to visualize the inside of the uterus. The purpose is to help in the diagnosis of endometrial polyps or fibroids, which may cause abnormal, heavy bleeding.

While lying on an examination table, the doctor will first insert a speculum into the vagina. Once the cervix (opening into the uterus) is visualized, the doctor will first cleanse the area with iodine. If you are allergic to iodine or shellfish, it is important to inform your doctor. Then he or she will inject a small amount of local anesthetic into the cervix. This will alleviate most discomfort for the remainder of the procedure. It is important to inform your doctor if you have ever had an allergic reaction to anesthetics in the past, such as dental freezing. The doctor will then insert the hysteroscope into the uterus. The hysteroscope is a small (about the diameter of a pencil or smaller), rigid instrument that contains a light source to allow visualization of the entire uterine cavity.

 The images will be displayed on a television monitor for both the patient and the physician to see. Sometimes women will report mild cramping as the hysteroscope is moved around in the uterus. At times, the doctor may instill a little fluid into the cavity to enable better visualization of its surface. The uterine cavity is normally collapsed. By instilling a little fluid, it distends the uterus enough to see all four walls. The procedure takes about 10 minutes. Most women will return to work after the procedure if they wish.

Risks are rare and include endometritis, air embolism and perforation of the uterus. Symptoms of endometritis (an infection in the lining of the uterus) include fever, foul-smelling vaginal discharge and a feeling of unwell-ness that lasts beyond 5 days post-procedure. In this instance, women are encouraged to return to the doctor’s office and take antibiotics until symptoms abate.

Air embolism is an extremely rare complication and is evident immediately after the procedure. This complication would require hospitalization.

Perforation of the uterus (puncture through the uterus to the abdominal cavity) does not often occur and is generally not serious. Patients are observed overnight and the perforation usually heals itself without any treatment. In rare instances, surgical intervention is required to repair a perforated uterus.

The physician will describe the findings and present recommendations for treatment.   It is common for woman to have slight vaginal bleeding for a few days after a hysteroscopy. Any excessive bleeding should be reported. Fever, abnormal vaginal discharge or unexplained pelvic pain are not expected and must be reported to the physician. Most women can expect to return to work the same day of the procedure and take over the counter painkillers such as acetaminophen or ibuprofen for cramping.