Hysteroscopy

Why this test may be ordered

• To diagnose the cause of abnormal uterine bleeding
• To help find the cause of infertility
• To find the cause of repeated miscarriages
• To find and remove fibroids and polyps
• To remove scar tissue from the uterus

Preparation and collection

Your provider will give you specific instructions. If you are receiving general anesthesia, you may need to fast for 6-12 hours before the procedure. Do not use douches, tampons, or vaginal medicines for 24 hours before the test. Schedule the procedure when you are not menstruating. Tell your provider about all medicines you take, and do not stop any unless instructed. Inform your provider if you are pregnant or think you might be, as hysteroscopy is not recommended during pregnancy. Also, inform your provider if you have a pelvic infection, cervical cancer, or pelvic inflammatory disease, as hysteroscopy is not recommended in these cases.

You will lie on your back with feet in stirrups. An IV line may be placed, and you may receive a sedative or general anesthesia. A speculum is inserted into the vagina to spread the walls, the cervix may be dilated, and the hysteroscope is inserted through the vagina and cervix into the uterus. Liquid or gas may be injected to expand the uterus for better viewing. The procedure takes 15 minutes to an hour.

A hysteroscopy is a very safe procedure. You may have mild cramping and a little bloody discharge for a few days afterward. Serious complications are rare but may include heavy bleeding, infection, or tears in the uterus. Call your provider if you have a fever, severe abdominal pain, or heavy vaginal bleeding.

Understanding results

Your healthcare provider will discuss the findings of your hysteroscopy with you.

• Normal: The inside of your uterus and cervix appear healthy, with no abnormal growths, scar tissue, or structural issues. Limitation: A normal result does not rule out all uterine conditions; your provider will interpret findings in the context of your symptoms and medical history. Next step: No further action may be needed unless your symptoms persist. Follow your provider's recommendations.
• Not normal: Abnormal findings such as fibroids, polyps, scar tissue, an abnormal uterine shape or size, or closed fallopian tube openings may be present. Limitation: These findings are visual observations; a biopsy may be needed to determine if growths are cancerous or noncancerous. Next step: Your provider may remove growths or scar tissue during the procedure or take a biopsy for further testing. Discuss the results and any recommended follow-up with your provider.

• Hysteroscopy is not recommended if you are pregnant, have cervical cancer, or have pelvic inflammatory disease.
• The procedure provides visual information; a biopsy may be needed for a definitive diagnosis of certain conditions.
• Serious complications are rare but can include heavy bleeding, infection, or uterine tears.
• Mild cramping and bloody discharge are common after the procedure.
• Results must be interpreted by a healthcare professional in the context of your overall health.

What to do next

After the procedure, your provider may recommend avoiding sex, tampons, douching, baths, swimming, or hot tubs for two weeks. Follow all post-procedure instructions provided by your healthcare team. If you have questions about your results, talk to your provider.

• What were the specific findings of my hysteroscopy?
• Were any growths or scar tissue removed during the procedure?
• Was a biopsy taken, and when will I get the results?
• What symptoms should I watch for after the procedure?
• When can I resume normal activities, including sexual activity and exercise?

Evidence source

U.S. National Library of Medicine: Hysteroscopy