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hysteroscopy for abnormal vaginal bleeding

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A hysteroscope is a small metal tube connected to a light source and camera. It magnifies the cervical opening, uterine cavity, and the openings of the fallopian tubes during a procedure called hysteroscopy.

Hysteroscopy may be:
  • diagnostic, in which case it is only used to view the organs and observe any obvious abnormalities
  • therapeutic, in which case surgery is done through the scope
It can be: Who is a candidate for the procedure? 
A hysteroscopy may be recommended:
  • if the source of bleeding is not found through a D & C
  • to aid in taking a biopsy, or tissue sample, from the lining of a woman's uterus after precancerous changes have been noted
  • to check the upper part of the cervix to see if a cancer stems from the cervix or the uterus
  • if a woman's medical history or a test suggests she has a uterine polyp or fibroid that might be removed by hysteroscopy
How is the procedure performed? 
A hysteroscopy is usually done in the first 2 weeks of a woman's menstrual cycle. This ensures she is not pregnant. It takes about 20 to 45 minutes and can be done: First, the cervix and vagina are cleansed. The cervix is opened so that the scope can be inserted into the uterus. The uterus is inflated with fluid or a harmless gas to make it easier to view. Any suspicious lesions (polyps, fibroids, ulcers, or growths) may be biopsied or removed using small tools placed in the scope. This tissue is sent for microscopic analysis. Pictures may be taken, too, before and after any surgery is done.

What happens right after the procedure? 
Recovery usually takes less than 2 hours. Results will vary according to the findings.
  • If a uterine polyp or fibroid was removed, symptoms of abnormal bleeding generally improve. They may recur if the base of the polyp or fibroid was not completely removed.
  • If precancerous changes in the uterine lining were diagnosed, further treatment with high-dose progesterones or hysterectomy may be needed.
The results and findings will be discussed during a follow-up visit in the doctor's office.

What happens later at home? 
Later a woman may:
  • feel sleepy or groggy from the anaesthesia
  • have menstrual-like cramps
  • retain more urine than usual
  • feel burning when urinating for a few hours after surgery
  • have watery vaginal discharge for 1 to 4 weeks
What are the potential complications after the procedure? 
Although this is a minor procedure, problems may occur, including:
  • problems related to anaesthesia, such as an allergic reaction or trouble breathing
  • pain during the procedure if local anaesthesia is insufficient
  • a puncture of the uterus, which may injure the bowel or bladder
  • infection of the cervix, uterine lining, or fallopian tubes
  • vaginal bleeding from blood vessels in the uterus or a torn cervix
  • too much fluid, which can cause salt imbalance, fluid in the lungs known as pulmonary oedema, or kidney shutdown, known as acute renal failure. This is more common when the procedure takes a long time and large amounts of fluid are used in the uterus.
Author: Eva Martin, MD
Reviewer: eknowhow Medical Review Panel
Editor: Dr John Hearne
Last Updated: 12/06/2005
Potential conflict of interest information for reviewers available on request

This website and article is not a substitute for independent professional advice. Nothing contained in this website is intended to be used as medical advice and it is not intended to be used to diagnose, treat, cure or prevent any disease, nor should it be used for therapeutic purposes or as a substitute for your own health professional's advice.  All Health and any associated parties do not accept any liability for any injury, loss or damage incurred by use of or reliance on the information.


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