How long does a hysteroscopy take?
Hysteroscopy is used to examine the inside of the uterus.
Hysteroscopy is a procedure performed by a gynecologist to inspect inside of the uterine cavity using a thin tube with a light and camera attached to it. This device is called a hysteroscope. A hysteroscopy may be performed as a diagnostic procedure to diagnose pathologies in the uterus or method for surgical treatment for uterine pathologies. This is called surgical or operative hysteroscopy. If a hysterectomy is only performed for diagnostic purposes, there is usually no pain besides mild discomfort. Hence, no anesthesia is required. Anxious patients may receive intravenous sedation. If a hysterectomy is done to perform surgical procedures, intravenous sedation or general anesthesia would be administered. Hence there would be no pain during the procedure. Patients may experience pain and discomfort after the procedure when the anesthesia wears off. Painkillers would be prescribed for this. Hysteroscopy can take anywhere between 5 to 30 minutes or longer if a surgical procedure is being performed at the same time. Surgical procedures to treat uterine pathologies can take between 30 minutes to 2 hours as well, depending on the procedure.
When is hysteroscopy done?
Hysteroscopy gives the doctor information about the patient’s reproductive health. It helps the doctor study the reproductive organs of a woman up close to identify abnormalities. A sample of abnormal tissues and masses would usually be taken for testing. This procedure is called a biopsy. Sometimes, an additional surgical procedure may be performed in certain conditions.
Hysteroscopy is indicated in the following situations
- To confirm the diagnosis of abnormalities that are suspected based on clinical assessment and other radiological tests, such as endometriosis, uterine adhesions, etc.
- Abnormal pap smear results
- Heavy or prolonged menstrual bleeding
- Dysmenorrhea (severe pain and cramping during periods)
- Intermenstrual bleeding (bleeding between periods)
- More than one miscarriage (loss of pregnancy)
- Difficulty getting pregnant
- Bleeding after menopause
- To evaluate the uterus prior to performing an abortion
- To diagnose and aid in the removal of uterine fibroids, uterine polyps and scarring of the uterus
- To undergo surgery for permanent sterilization
- If the intrauterine contraceptive device (IUCD) is displaced from the uterus
What happens during a hysteroscopy?
The anesthesia used in hysterectomy depends on whether the procedure is done for diagnosis or to perform a procedure. If the procedure is only performed for diagnostic purposes, no anesthesia is required. Anxious patients may receive intravenous sedation. If the procedure is performed to take a biopsy or to perform more invasive procedures, intravenous sedation or general anesthesia would be administered.
The doctor first spreads the cervix with a tool called a speculum like in a routine gynecological exam. The doctor then inserts the hysteroscopy device through the vagina, the cervix and then into the uterus. A liquid (saline) or carbon dioxide gas is passed into the uterus through the device to clean and inflate the uterus to make the diagnostic or surgical procedures easier to perform. The procedure may take anywhere between 5 to 30 minutes depending on the procedure.
What happens after a hysteroscopy?
The recovery time after a hysteroscopy depends on why it was performed. If patients have not received anesthesia or just local anesthesia, they would be able to go home in 1 to 2 hours. Those who receive intravenous sedation or general anesthesia would have to stay in the hospital until they recover from the anesthesia, which may take a few hours to 24 hours. Painkillers and antibiotics may be administered. After the procedure, the patients may experience the following
- Pain and discomfort
- Cramps
- Vaginal bleeding (usually mild) or spotting for 1 to 2 days
- Pain radiating to the shoulder (if carbon dioxide gas was used)
- Nausea
- Lightheadedness or giddiness
Is hysteroscopy safe?
Hysteroscopy is a relatively safe procedure with minimal complications. Though rare, like any procedure there is a risk of complications, which include
- Bleeding
- Infection
- Injury to the cervix or uterus
- Scarring of the uterus
- Reaction to the liquid used to clean the uterus
- Reaction to anesthesia