A hysteroscopy is a way for your doctor to look at the lining of your uterus. He or she uses a thin viewing tool called a hysteroscope. The tip of the hysteroscope is put into your vagina and gently moved through the cervix into the uterus. The hysteroscope has a light and camera hooked to it so your doctor can see the lining (endometrium) on a video screen.

A hysteroscopy may be done to find the cause of abnormal bleeding or bleeding that occurs after a woman has passed menopause. It also may be done to see if a problem in your uterus is preventing you from becoming pregnant (infertility). A hysteroscopy can be used to remove growths in the uterus, such as fibroids or polyps.

Your doctor may take a small sample of tissue (biopsy). The sample is looked at under a microscope for problems. Another surgery, called a laparoscopy, may also be done at the same time as a hysteroscopy if infertility is a problem.

Why It Is Done

A hysteroscopy may be done to:

• Find the cause of severe cramping or abnormal bleeding. Your doctor can pass heated tools through the hysteroscope to stop the bleeding.
• See whether a problem in the shape or size of the uterus or if scar tissue in the uterus is the cause of infertility.
• Look at the uterine openings to the fallopian tubes. If the tubes are blocked, your doctor may be able to open the tubes with special tools passed through the hysteroscope.
• Find the possible cause of repeated miscarriages. Other tests may also be done.
• Find and remove a misplaced intrauterine device (IUD).
• Find and remove small fibroids or polyps.
• Check for endometrial cancer.
• Use heated tools to remove problem areas in the lining of the uterus (endometrial ablation).
• Place a contraceptive implant (such as Essure) into the opening of the fallopian tubes as a method of permanent sterilization.

How To Prepare

Tell your doctor if you:

• Are or might be pregnant.
• Are taking any medicines.
• Are allergic to any medicines.
• Have had bleeding problems or take blood-thinners, such as aspirin or warfarin (Coumadin).
• Have been treated for a vaginal, cervical, or pelvic infection in the past 6 weeks.
  Have any heart or lung problems.
  It is best to have a hysteroscopy done when you are not having your menstrual period. If there is a chance that you could become pregnant, the hysteroscopy should be done before you are ovulating so your doctor is sure you are not pregnant.

Do not douche, use tampons, or use vaginal medicines for 24 hours before the hysteroscopy.

How its done

A hysteroscopy is usually done by your gynecologist and most women go home the same day. You may be given medicine to help you relax, to numb the area, or to help you sleep.

You will take off all of your clothes and wear a gown for the test. You will empty your bladder before the test. You will then lie on your back on an examination table with your feet raised and supported by footrests (stirrups).

A lubricated tool called a speculum will be inserted into your vagina. The speculum gently spreads apart the vaginal walls so your doctor can see inside the vagina and the cervix. Your vagina will be cleaned with a special soap.

The hysteroscope will be placed at the entrance to your vagina and gently moved through the cervix into your uterus. A gas or liquid will be put through the hysteroscope into your uterus to help your doctor see the lining clearly. Your doctor looks through the hysteroscope at a magnified view of the lining of your uterus. Your doctor can also see the uterine openings of the fallopian tubes. A video screen may be used during the test.

If a biopsy or other procedure is done, your doctor will use small tools through the hysteroscope. A hysteroscopy takes about 30 minutes, unless other procedures are being done.