Hysteroscopy is a procedure, which is done for the evaluation of the uterine cavity and
treatment of intracavitary pathology. It allows physicians to diagnose and correct many
gynecologic disorders on an outpatient or daycare basis. Patient recovery time is short and
significantly less than from any abdominal surgery done through larger incisions.
Definition – It is the direct visual inspection of the cervical canal and uterine cavity
through a hysteroscope (a long, thin, lighted, telescope- like instrument).
Video of Diagnostic Hysteroscopy- Unicornuate uterus (half uterus)
Hysteroscopy can diagnose and treat uterine pathologies such as endometritis,
endometrial atrophy, endometrial polyps, submucus fibroids, intrauterine synechaie
and malformations of the uterus. These contribute to a hostile environment for the
implanting embryo and also impair placentation or growth of the fetus, thus are
important to be diagnosed and treated before performing embryo transfer.
Procedure – the procedure is done under short general anesthesia/ local
anesthesia or deep sedation. The cervical canal is dilated with a series of dilators so
that the hysteroscope can go through it. No skin incision is required as the
procedure is done transvaginal.
Fluid such as normal saline is injected through the same instrument, so that the
uterine cavity expands and the internal structures of the uterus can be seen.
Diagnostic hysteroscopy takes just about 5 – 10 minutes to perform. It is often done
soon after menstruation has ended because the uterine cavity is more easily
If any polyp, synechaie or any other pathology is detected it is corrected usually in
the same sitting. Some structural abnormalities, such as a uterine septum, can also
Risks of Hysteroscopy
Complications of hysteroscopy occur in about 2 out of every 100 procedures.
Although still uncommon, perforation of the uterus (a small hole in the uterus) is the
most common complication. Although perforations usually close spontaneously,
they may cause bleeding or rarely result in damage to nearby organs, which may
require further surgery. Very rarely uterine cavity adhesions or infections may
develop after hysteroscopy. Severe or life-threatening complications, however, are
The patient is discharged the same day after about 3-4 hours of observation.
Following hysteroscopy, some vaginal discharge or bleeding and cramping may be
experienced for several days. Most physical activities can usually be resumed within 1 or 2 days.
Instruments used in diagnostic Hysteroscopy