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Hysteroscopy is a technique for visually examining the cavity of the uterus using a long, thin telescope-like instrument (hysteroscope) that is inserted through the vagina and cervix.  A small video camera attached to the end of the telescope gives the doctor a magnified view on a video monitor.

Video demonstration of hysteroscopy:

Hysteroscopy can be either diagnostic or therapeutic, or both.  Therefore, it is sometimes referred to as diagnostic hysteroscopy (when used for viewing only) and sometimes as operative hysteroscopy (when used for treatment).  It may be performed in the doctor’s office under local anesthesia, and a woman can return to her normal activities immediately that day or the next (if intravenous sedation is used).

Diagnostic hysteroscopy

As a diagnostic tool, hysteroscopy is useful in identifying causes of abnormal uterine bleeding and dysmenorrhea, such as fibroids, adhesions and polyps.  It is also used to further evaluate abnormalities noted on certain diagnostic tests such as a hysterosalpingogram, sonogram or endometrial biopsy.

Surgical procedures to correct some of these problems can be carried out with operative hysteroscopy, using special instruments that fit through channels of the hysteroscope.

Operative hysteroscopy

Operative hysteroscopy is also used to perform a minimally invasive procedure for women who choose sterilization as a means of permanent birth control.

A hysteroscope is a long, slender telescopic device that is used to view the inside of the uterus.  It is used not only to diagnose such conditions as fibroids, adhesions and polyps (diagnostic hysteroscopy), but also to treat them (operative hysteroscopy).  Instruments designed to fit through a channel in the hysteroscope are used to remove growths or scar tissue or to correct certain congenital abnormalities such as a uterine septum.

Because the uterine cavity is a potential one, it must be inflated with either a harmless gas or fluid to make space for viewing and operating.  This can cause cramping similar to menstrual cramps.  Afterwards, depending on the procedure performed, there may be vaginal discharge or bleeding for several days.

Operative hysteroscopy allows many procedures that once required hospitalization to be performed in the doctor’s office with minimal discomfort and quick recovery.  Patients are usually ready to resume normal activities after a day or two.  Some of these procedures replace the need for hysterectomy.

Risk of serious complications is low; however, perforation of the uterus, uterine adhesions (scar tissue) or infection may occur in about 2% of procedures.

Diagnostic HysteroscopyDilation and Curettage

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