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hysteroscopy for intrauterine defect

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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:
  • used to find and sometimes treat suspected defects in the uterus
  • combined with dilatation and curettage (D & C) or laparoscopy to evaluate and sometimes treat infertility or other gynecological problems
Who is a candidate for the procedure? 
Hysteroscopy may be recommended to evaluate a woman's infertility. Often it is done after a test called a hysterosalpingogram picks up possible defects in the uterus. It may also be done if the following conditions are suspected:
  • uterine polyps, or non-cancerous tumours
  • fibroids, which are growths in the uterus that are non-cancerous
  • a wall, or septum, dividing the uterus
  • an abnormally shaped uterus
  • foetal tissue remaining after a miscarriage or abortion
  • a lost IUD, or intra-uterine device
  • scarring on the lining of the uterus, known as Asherman's syndrome
  • unexplained infertility
How is the procedure performed? 
For 1 to 2 months beforehand, a woman may be given medications to block the build-up of the uterine lining. This makes it easier to view the inside of the uterus.

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 may be biopsied or removed using small tools placed in the scope. This tissue is sent for microscopic analysis. Pictures may be taken with a special camera before and after any surgery is done.

What happens right after the procedure? 
Recovery usually takes less than 2 hours. Results will vary as will future treatment options.

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

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