Office Hysteroscopy

A hysteroscopy is a test that lets your doctor examine the inside walls of your uterus. The procedure is done in our accredited Ambulatory Surgery Center (ASC) on site.

To the right is a picture of a normal uterus

Having an abnormality in your uterus can reduce your chances for pregnancy. A hysteroscopy is a test that uses sterile salt water and a tiny telescope to visualize the inside of your uterus. The test is able to detect scar tissue (see photo below), polyps, fibroids, and any uterine abnormality such as a septate uterus, that may prevent an embryo from implanting properly.

 Above is a picture of uterine adhesions (Asherman's syndrome) 

What to expect during the hysteroscopy

The hysteroscopy is usually done in our office and takes about 30 minutes. A speculum is inserted into your vagina (like when you have a Pap smear). A local anesthetic is then given, and then a tiny telescope with a camera is placed through your cervix into the uterine cavity. The sterile salt water is instilled into the uterus so that you can see the walls. There is a TV monitor allowing you and your doctor to visualize the inside of the cavity. We have the latest in office hysteroscopy equipment, including a 3.9 mm hysteroscope which results in significantly less patient discomfort compared to the older 5 mm hysteroscopes, and usually allowing no need to dilate the cervix.

 Questions and Answers

Q: A friend of mine had a hysteroscopy and she said it was uncomfortable. Is that true?

A: Many women feel some cramping, especially when the sterile salt water is instilled. Women with blocked fallopian tubes may feel more uncomfortable. Even though we are using the smallest hysteroscope available, We do recommend that one hour before the procedure you take 2-3 pills of regular ibuprofen (Motrin, Alleve) to help prevent or reduce cramps during the procedure.

Q: Is it OK to drive home by myself after the test?

A: Many women have no pain after the hysteroscopy, but you may feel a little cramping. You should be able to drive yourself, and return to work after the procedure.

Q: What are the risks of a hysteroscopy?

A: The risks of the hysteroscopy include pain or discomfort, infection, and vaginal spotting or bleeding. Contact your doctor if you develop a fever, continue bleeding, or continue to feel pain. We have not had any infections or other complications in more than 1000 cases to date. You may have some spotting for 2-3 days after the procedure.

Q: When is the best time during my cycle to schedule the hysteroscopy?

A: You should call the office with the first day of full flow so that we can schedule the test. The hysteroscopy is usually scheduled after your period ends, but before you expect to ovulate, usually between days 6-12 of your menstrual cycle. You need to use protection during intercourse prior to the test. You may resume intercourse without protection 24 hours after the procedure.

Hysterosalpingogram (HSG)

The HSG is a procedure in which a special type of x-ray using a fluoroscope is taken of the uterus and fallopian tubes after a radio-opaque dye is introduced into the uterus through the cervix. This procedure outlines the interior contour of the uterus and determines if the fallopian tubes are open (tubal patency) or if after an Essure procedure, identifies the satisfactory placement of the Essure micro-inserts within the tubes. If performed after an Adiana procedure, the HSG will note if the tubes are open or appear occluded by x-ray.

You will be asked to undress completely from the waist down. A speculum is then placed into the vagina and the cervix is cleansed with an antiseptic (Betadine or Hibiclens). After the cervix is cleansed, local anesthetic (Lidocaine) is used to numb the cervix prior to placement of an instrument which holds the cervix in position. Rarely, one may feel a slight pinch and a 2 second burn from the injection, however, the majority of women feel nothing. You will not feel any discomfort from the instrument being placed on the cervix. At this point, another instrument (cannula) is then placed 1 cm into the cervical canal and radio-opaque contrast dye is injected slowly into the uterus. Some women may experience some discomfort similar to light menstrual cramps as the dye enters the uterus, however, the majority do not. X-rays will be taken as the dye fills the uterus and the fallopian tubes. After the procedure is completed, based on your preference, a tampon can be inserted, or you may use a pad, since some of the contrast will leak out into the vagina. While the contrast dye itself is clear, you can expect to have some spotting over the next few days as result of the instrument placed on your cervix. The entire procedure is usually completed within 5 minutes. We recommend you abstain from intercourse for 24-48 hours after the HSG in order to minimize any risk of infection.