Hysteroscopy is a procedure that allows a surgeon to look inside of your uterus in order to diagnose and treat the causes of abnormal bleeding. Hysteroscopy is done using a hysteroscope, a thin, lighted tube that’s inserted into your vagina to examine your cervix and the inside of your uterus. An operative hysteroscopy can be used to remove polyps, fibroids and adhesions.
Hysteroscopy is primarily used to diagnose and treat the causes of abnormal uterine bleeding. The procedure allows your surgeon to look inside of your uterus with a tool called a hysteroscope. A hysteroscope is a thin, lighted tube that a surgeon inserts through your vagina to examine your cervix and the inside of your uterus.
Hysteroscopy can be a part of the diagnostic process, as well as the treatment process.
Diagnostic hysteroscopy identifies structural irregularities in your uterus that may be causing abnormal bleeding. Hysteroscopy may also be used to confirm the results of other tests, such as an ultrasound or hysterosalpingography (HSG). HSG is an X-ray dye test used to check whether your fallopian tubes are blocked. Blocked fallopian tubes may make it difficult to become pregnant.
Operative hysteroscopy treats an abnormality detected during a diagnostic hysteroscopy. Your provider may perform a diagnostic and operative hysteroscopy at the same time, avoiding the need for a second surgery. During operative hysteroscopy, your surgeon uses a device to remove abnormalities that may be causing abnormal uterine bleeding.
Endometrial ablation is a procedure that treats abnormal uterine bleeding. Your surgeon uses the hysteroscope to look inside your uterus before using a device to destroy your uterine lining.
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Your doctor may perform hysteroscopy to diagnose and correct the following uterine conditions:
Hysteroscopy may also be used to:
Your surgeon will review your medical history and evaluate your current health to determine whether a hysteroscopy is appropriate. Although there are many benefits associated with hysteroscopy, it’s not right for everyone. For example, you shouldn’t have a hysteroscopy if:
If your periods are regular, your surgeon will likely recommend scheduling your hysteroscopy for the first week after you stop bleeding. This timing will allow the best view of the inside of your uterus. If you have irregular menstrual cycles, you may need to work with your surgeon to find the best time for your hysteroscopy. The procedure can take place at any time if you’ve gone through menopause.
Your surgeon will ensure you’re a good candidate for a hysteroscopy, talk you through the procedure and answer any questions you may have. You’ll receive instructions so you’re prepared for your procedure.
Your provider may:
On the day of the procedure, you’ll be asked to empty your bladder and change into a hospital gown. You may receive anesthesia or a sedative to help you relax. The type of anesthesia you receive depends on whether the hysteroscopy will take place in a hospital or your surgeon’s office and whether other procedures will occur simultaneously.
You’ll be positioned on the exam table with your legs in stirrups. Once you’re in position, your surgeon will:
A hysteroscopy can last anywhere from five minutes to more than an hour. The length of the procedure depends on whether it’s diagnostic or operative and whether an additional procedure, such as laparoscopy, is done simultaneously. Diagnostic hysteroscopy usually takes less time than operative.
If you received anesthesia during your hysteroscopy, you might be observed for several hours in the recovery room. You may have some cramping or light bleeding that lasts for a few days. It’s also not unusual to feel somewhat faint or sick immediately following your procedure.
Hysteroscopy is considered minor surgery and usually doesn’t require an overnight hospital stay. If your provider is concerned about your reaction to anesthesia, you may need to stay overnight.
Hysteroscopy can allow your surgeon to diagnose and treat conditions with a single surgery. In addition, a hysteroscopy enables surgery that’s both minimally invasive and precise. Hysteroscopy can allow your surgeon to locate abnormalities and remove them without damaging surrounding tissue.
Hysteroscopy is considered a safe procedure. As with any surgery, complications can occur. With hysteroscopy, complications occur in less than 1% of cases and can include:
Your recovery time depends on how extensive your procedure was — for instance, if your hysteroscopy was both diagnostic and operative. People recovering from a hysterectomy are often advised to avoid douching, intercourse or inserting anything into their vagina (like tampons) for two weeks following the procedure. You may be advised to avoid baths, swimming and hot tubs during your recovery.
Follow your surgeon’s guidance based on your unique situation.
Contact your provider if you experience any of the following symptoms:
Everyone’s experience is different. Studies have shown that factors like how long the procedure is, whether or not a person has given birth before and how anxious a person is prior to surgery may affect their pain perception during hysteroscopy.
Speak with your surgeon about your concerns. Ask about what you can expect to feel during your hysteroscopy. Ask about what type of anesthesia you’ll receive in order to remain comfortable throughout the procedure.
It depends. Anesthesia for hysteroscopy may be local, regional or general. General anesthesia will put you to sleep.
If you're having general anesthesia, you may not be able to eat or drink for a certain amount of time before the hysteroscopy.
An operative hysteroscopy is considered minor surgery. It doesn’t usually require a hospital overnight stay. Unlike more invasive procedures that open your abdomen to access organs, a hysteroscopy can be performed through your vagina.
No. Both a D&C (dilation and curettage) and an operative hysteroscopy allow your surgeon to remove tissue from your uterus. While a hysteroscopy enables your provider to find growths and remove them with precise surgical instruments, a D&C allows your surgeon to sample greater amounts of tissue from your uterine lining by performing a gentle scraping.
You shouldn’t be. Hysteroscopy is widely considered a safe procedure, with minimal risks involved.
A note from Cleveland Clinic
Hysteroscopy allows your provider to diagnose and treat a variety of conditions that may be causing abnormal bleeding. To prepare for your hysteroscopy, ask your surgeon about the specifics of your procedure, including how long it will last and what your recovery period will be like. Ask if additional procedures will occur simultaneously, like a laparoscopy. Understanding what’s involved during the day of your procedure and in the weeks ahead can provide you peace of mind as you prepare for your hysteroscopy.
Last reviewed by a Cleveland Clinic medical professional on 09/12/2022.
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