What is a Hysteroscopy?
This is a procedure where a doctor uses a thin tube with a camera to look inside the uterus. Saline solution is used to expand the uterus in order to look inside of the uterus. There are no incisions.
When is this surgery used?
This procedure allows us to see any abnormalities in your uterus.
To evaluate and or treat diseases of the uterus
- Recurrent miscarriages
- Lost or retained IUD, will be removed if seen.
- Heavy or irregular vaginal bleeding, a scraping will be obtained.
- Inability to obtain an office endometrial sampling will be obtained.
- Scar tissue inside the uterus, will be cut out or use electrical energy to remove
- Endometrial polyps will be removed using electrical energy or cut out.
- Sub mucosal fibroids, will be removed using electrical energy or cut out.
- Permanent sterilization (Essure), these devices will be placed into the openings of the Fallopian tubes.
How do I prepare for surgery?
- Depending on your health, we may ask you to see your primary doctor, a specialist, and/or an anesthesiologist to make sure you are healthy for surgery.
- Some medications may need to be stopped before the surgery. A list of medications will be provided at your pre-operative appointment.
- Smoking can affect your surgery and recovery. Smokers may have difficulty breathing during the surgery and tend to heal more slowly after surgery. If you are a smoker, it is best to quit 6-8 weeks before surgery. If you are unable to stop smoking before surgery, your doctor may order a nicotine patch while you are in the hospital.
- You will be told at your pre-op visit whether you will need a bowel prep for your surgery and if you do, what type you will use. The prep to clean your bowel will have to be completed the night before your surgery.
- You will need to shower at home before surgery. Instructions will be provided at your pre-operative appointment.
- Do not wear makeup, nail polish, lotion, deodorant, or antiperspirant on the day of surgery.
- Remove all body piercings and acrylic nails.
- If you have a “Living Will” or an “Advance Directive”, bring a copy with you to the hospital the day of surgery.
- Plan for your care and recovery for after your surgery is complete . Most women recover and are back to most activities in 1-2 days.
What can I expect during the surgery?
- In the operating room, you will be given either a general , spinal , or a local anesthesia. The choice of anesthesia is a decision that will be made by the anesthesiologist based upon your history and wishes.
- If a general anesthesia is given, after you are asleep and before the surgery starts:
- A tube to help you breathe will be placed in your throat.
- Another tube will be placed in your stomach to remove any gas or other contents to reduce the likelihood of injury during the surgery. The tube is usually removed before you wake up.
- A catheter will be inserted into your bladder to drain urine and to monitor the amount of urine coming out during surgery. The catheter will stay in until the next day.
- Compression stockings will be placed on your legs to prevent blood clots in your legs and lungs during surgery.
- Your cervix will be dilated and then the hysteroscopy is placed through the cervix into the uterus. Fluid is instilled into the uterus for better visualization.
- A dilation and curettage is often performed at the same time to remove tissue for any further testing.
- Photographs may be taken during the surgery and placed in your medical records for future reference.
What are possible risks from this surgery?
Although there can be problems that result from any surgery, we work very hard to make sure it is as safe as possible. However, problems can occur, even when things go as planned. You should be aware of these possible problems, and what will be done to correct them..
Possible risks during surgery include:
- Bleeding: If there is excessive bleeding, you will be given a blood transfusion unless you have personal or religious reasons for not wanting blood. This should be discussed with your doctor prior to the surgery.
- Damage to the bladder, ureters the tubes that drain the kidneys into the bladder), uterus, and to the bowel: Damage can occur in less than 1% of surgeries. If there is damage to the bladder, ureters, uterus, or to the bowel they will be repaired while you are still in surgery.
- Death: All surgeries have a risk of death. Some surgeries have a higher risk than others.
Possible risks that can occur days to weeks after surgery:
- A blood clot in the legs or lung: Swelling or pain, shortness of breath, or chest pain are signs of blood clots. Call you doctor immediately if any of these occur.
- Bowel obstruction: A block in the bowels that results in not being able to pass stool or gas. May cause stomach pain, bloating or vomiting.
- Scar tissue: Tissue thicker than normal skin forms at the cervix or uterus.
- Infection: Fever, redness, swelling or pain at the site of surgery.
What happens after the surgery?
- You will be taken to a recovery room and monitored for a short time before going home.
- You will be given medications for pain and nausea as needed.
- You will have the compression stockings on your legs to improve circulation and to help prevent the formation of blood clots.
- You may have some vaginal spotting of bright red, brown, or black discharge. This is normal.
- You may have a scratchy throat if a general anesthetic was used.
- You will start walking as soon as possible after the surgery to help the healing and recovery process.
At Home After Surgery
Call your doctor right away if you experience :
- develop a fever over 100.4°F (38°C)
- have pain with urination
- start bleeding like a menstrual period or (and) are changing a pad every hour
- have heavy vaginal discharge with a bad odor
- have severe pain in your abdomen or pelvis that pain medication is not helping
- have nausea and vomiting
- develop swelling, redness, or pain in your legs
- develop a rash
- have chest pain or difficulty breathing
- Vaginal Bleeding: You may have some vaginal spotting of a watery bright red, brown, or black discharge for up to 3-4 weeks. You may have abdominal cramping for 48 hours.
- Diet: You will continue with your regular diet.
- Pain: Medication for pain will be prescribed for you after surgery. Do not take it more frequently than instructed.
- Nausea: Anti-nausea medication is not typically prescribed. Tell your doctor if you have a history of nausea with general anesthesia.
- Energy level: It is normal to have a decreased energy level after any surgery. After you are home, you should minimize any strenuous activity for the first day or two. It is very important not to overdo, but once you settle into a normal routine at home, you will find that you slowly begin to feel better. Walking around the house and taking short walks outside can help you get back to your normal energy level quicker.
- Showers: Showers are allowed within 24 hours after your surgery. Do not take baths for at least 1 week after surgery.
- Climbing: Climbing stairs is permitted, but you may require assistance initially.
- Lifting: For 1-2 days after your surgery you should not lift anything heavier than a gallon of milk. This includes pushing objects like a vacuum cleaner and vigorous exercise.
- Driving: The reason you are asked not to drive after surgery is because you may be prescribed medications that may impair your ability to drive. You should not drive or operate heavy machinery for 24 hours after surgery.
- Exercise: Exercise is important for a healthy lifestyle. You may resume normal physical activity within hours of surgery. Start with short walks and gradually increase the length of time and distance that you walk. To allow your body enough time to heal, you should not return to a more difficult exercise routine until 2 days after your surgery. Please talk to your doctor about when you can begin exercising again.
- Intercourse: No sexual activity for 2 weeks after surgery.
- Work: Most patients can return to work between 1-2 days after surgery. You may continue to feel tired for a couple of weeks.
Contact your doctor office if you have any concerns.