Hysteroscopy

What is a hysteroscopy?

  • A hysteroscopy ("scope") is an amazing, easy way of examining the inside of your uterus (womb) without pain.  
  • We use a very small camera on the end of a thin straw (hysteroscope) and gently put this straw into your cervix (like a pap test) and look inside your uterus. This allows us to look directly into the space (cavity) of your uterus to see if there are any polyps, visible fibroids or other concerns in the uterus.
    • We always give you local anesthetic before inserting the hysteroscope.  
    •  You are always awake. You do not need a General Anesthetic for a simple Hysteroscopy (that is old fashioned)  
    • The hysteroscopy is not painful. We talk to you throughout and show you the images on our new monitor system and always make sure you are feeling okay.  
    • Our new viewing system allows you to be a part of the examination. As we proceed, you can see the inside of your uterus on a screen (like the Discovery Channel) and we can explain to you what you see and answer any questions you have.  
    • The hysteroscopy itself will take less than 5 - 10 minutes. We have to do some preparation before-hand, so set aside 30 minutes to one hour for the visit. There is usually no need for time to recover afterwards.  
    • Sometimes, a sample of your uterine lining (endometrial curettage/sampling) will be taken or a small polyp removed. This is always sent to a lab to check for abnormal cells.  
    • The endometrial sampling can cause some cramping. We will always give you pain pills (analgesic) and an anti-inflammatory to take before the procedure.  
    • If you have a small polyp, we can sometimes take it out at the same time. This will not be painful.

    Why do I need a hysteroscopy? 

    • A hysteroscopy is the best way of examining the inside of your uterus.  
    • It will give us more exact information than an ultrasound or a sonohysterogram, of the inside of the uterus cavity.  
    • If you have irregular bleeding, heavy periods, spotting between periods or post menopausal bleeding, the hysteroscopy may help us in finding the cause of the abnormal bleeding.  
    • If you have a uterine polyp, this can usually be removed easily during the procedure.  
    • If you have fibroids on the inside of the uterine wall, we will be able to localize them through the hysteroscopy, and evaluate how they can be removed.  
    • If your IUD is a little stuck inside and needs to be removed.  
    • The hysteroscopy will tell us if your uterus and its lining look normal or if there is anything to be concerned about.  
    • Taking an endometrial sample will detect any abnormal cells that may need further investigations and treatment.  
    • If you had an ultrasound showing a thickened endometrium (uterine lining), taking a sample will identify why this is happening, especially if you are menopausal.

    Is a hysteroscopy safe?

    • A diagnostic hysteroscopy is very safe. We are just looking inside your uterus with a tiny camera and sometimes taking a sample of tissue 
    • This is done with direct vision, so we see everything and know where we are at all times. 
    • As with any medical procedure, there is always a small risk of infection or light bleeding afterwards. The risk of infection is less than 5% (closer to 1%)
    • The chance of causing damage to the uterus wall is very, very small.
    • The likelihood of causing damage to surrounding tissue or organs including the bladder, bowel and blood vessels is very rare.

    Before the hysteroscopy...

    • It is important that you know about the procedure, why it is being done and what you can expect to achieve from having it.  
    • You should never have any procedure done without being fully informed about it, understanding other options and the possible side effects and risks. Never feel shy or intimidated to ask questions before a procedure or treatment is done!
    • We will give you all the information at a separate appointment before the procedure. Please feel free to ask questions if there is anything you want to know more about.  
    • We will give you some medication to take one hour before the hysteroscopy if you wish. These include anti-inflammatories and analgesic medications.  
    • Sometimes, depending on which medicines you take before the "scope" you cannot drive or operate dangerous equipment (stove tops or blenders!) for the next 12 to 24 hours. This is a precaution to protect you in case you are a little drowsy or not alert.  
    • You will then need someone to drop you off and pick you up from the visit. We will tell you if this applies to you.  
    • It is preferable to do the hysteroscopy when you are not bleeding. If you have periods, you should book the hysteroscopy just after a period. If you have irregular bleeding, try to book the visit when you think you will not be bleeding. If you are bleeding heavily the day before the visit, please call us to reschedule. If you are just spotting or bleeding lightly, we can usually perform it anyway.

    Please let us know if you...

    • Are or might be pregnant.  
    • Are taking any medicines.  
    • Are allergic to any medicines.  
    • Have had bleeding problems (bleed easily) or take blood-thinners, such as Aspirin (ASA) or Warfarin (Coumadin).  
    • Have been treated for a vaginal, cervical, or pelvic infection in the past 4 weeks.  
    • Have any heart or lung problems. (including stents, valve problems etc)  
    • Have an artificial joint (e.g. hip or knee replacement)

    ...and afterwards

    • You may have some cramping after the hysteroscopy. This usually lasts about 15 minutes. Sometimes it lasts longer, like a period cramp. Ibuprofen, (such as Advil or Motrin), every 6-12 hours will help relieve this.  
    • It is normal to have light bleeding or spotting after a hysteroscopy. This usually lasts for a few days.  
    • Because of a slight risk of infection, we recommend not putting anything in your vagina for about 7 days after the procedure. This means no vaginal intercourse and no tampons.  
    • Shower instead of taking baths the first 7 days after the procedure.  
    • Resume normal activities as soon as you are able to. The sooner the better.  
    • Please book your next visit with us in a few weeks, to discuss results and to make future plans.  

    Please note...
    You need to see us immediately if any of the following occurs:

    • Fever / chills  
    • Headache / dizziness  
    • Increased abdominal pain that does not go away with pain medication  
    • Increased / prolonged bleeding  
    • Foul-smelling vaginal discharge.  
    • Difficulty passing urine

    Call us or come to the office. We are open Mon-Fri 8-5.
    After-office hours go to ER.
    Our phone number is 416-484-8383.