Hysteroscopy

Medically reviewed by Michael Weber, MD on June 27, 2017Written by Diana K. Wells

Overview

A hysteroscopy is a procedure in which your doctor inserts a small-diameter device into your uterus. This device has a light and a small camera on the end to allow the doctor to see inside your uterus.

There are a number of situations in which your doctor may recommend this procedure. It can be used for either surgical or diagnostic purposes. It may be used:

  • for visual confirmation of another test result
  • to aid in the removal of fibroids and polyps
  • in conjunction with a laparoscopic procedure
  • prior to a dilation and curettage procedure
  • to discover any malformation of the uterus

Procedure

Your primary doctor may refer you to a specialist for this procedure. The procedure will take place with you in the same position as you’re normally in for a gynecological exam, with your feet in the stirrups at the end of the exam table.

During a hysteroscopy:

  • The doctor will first spread the cervix with a tool called a speculum. This is also like what happens during a gynecological exam.
  • The doctor will then insert the hysteroscopy device in through your vaginal opening. They will continue moving it through the cervix and then into the uterus.
  • A liquid or carbon dioxide gas will then be gently sent into your uterus through the device to clear the surface and to help widen it slightly.
  • The light and camera on the end of the hysteroscope allow the doctor to see the uterus and fallopian tubes. This allows them to diagnose any issues or to perform any surgical procedures necessary.

If the procedure is being used for surgery, the surgical devices will also be put through the hysteroscope tube to perform the surgery.

The procedure shouldn’t be painful. However, you may experience some cramping during the procedure. Your doctor may order some type of sedative for you to take beforehand so that you’ll be more relaxed. The extent of anesthesia you need will depend on the purpose of your hysteroscopy. It’ll also depend on where you have your hysteroscopy. It can be done either in your doctor’s office or at a hospital.

The procedure itself can take anywhere from just 5 minutes to 30 minutes depending on what’s being done.

For most diagnostic-only purposes, the hysteroscopy can be done in your doctor’s office with just local or regional anesthesia. This is typically true for the simple removal of small polyps as well. When the hysteroscopy is being used in conjunction with a more in-depth surgical procedure, it may be done in a hospital. In that case, the doctor will use a regional or general anesthesia, depending on the extent of the surgery that’s required.

Recovery

The purpose of the hysteroscopy will determine the length of recovery. However, there are some general things that are common after any hysteroscopy procedure. You may experience the following:

  • cramping
  • slight bleeding or spotting for a day or so
  • shoulder pain (if carbon dioxide gas was used)
  • mild nausea
  • lightheadedness or dizziness

You’ll be able to eat or drink immediately following the hysteroscopy.

If you have your procedure in the doctor’s office with just a local anesthesia, then you’ll typically be able to leave in less than an hour.

If your procedure requires regional anesthesia, your doctor may want you to wait until the effects have worn off before sending you home. This may also take less than an hour, but it could take longer depending on the amount of anesthesia used.

If your procedure requires general anesthesia, then it’s still an outpatient procedure. You’ll be able to return home after a few hours. Your doctor will only require an overnight stay in the hospital for observation if you have had a past reaction to anesthesia.

In some cases, your doctor may prescribe a pain medication to make recovery easier. If surgery is involved, then your doctor may have you rest for a day or two before resuming a normal schedule. Follow your doctor’s instructions for recovery. For a hysteroscopy that isn’t purely diagnostic, you should refrain from sexual activity for about a week. This helps reduce the chance of infection.

Cost of a hysteroscopy

You can expect the cost of a hysteroscopy to range from $750-$3,500. The cost depends on the extent of the procedure. For instance, a diagnostic-only procedure is much less than one involving surgery. The cost may be higher if you have a more extensive procedure which includes surgery in the hospital and general anesthesia. Costs for these extensive procedures can be up to $7,000.

Some health insurance carriers will cover a hysteroscopy, at least partially, when it’s considered medically necessary. Coverage varies from policy to policy, so talk to your insurance carrier to determine your out-of-pocket costs.

Complications

A hysteroscopy is considered a fairly safe procedure with minimal complications. However, it’s still considered surgery. Because of this there are some possible complications, though they are not common. They include:

  • infection
  • scarring of the uterus
  • heavy bleeding
  • a reaction to anesthesia or the liquid used to clean the uterus
  • any side effects associated with the use of anesthesia

You should contact your doctor immediately if you experience any of the following:

  • heavy bleeding
  • fever
  • chills
  • severe pain

Outlook

Your doctor may suggest a hysteroscopy for several different reasons. These are situations where a closer look or minor surgery may be required for your long-term health and well-being. If you have questions, be open and honest with your doctor. Ask any questions that you need to.

The risks with a hysteroscopy are extremely low, but should still be discussed with your doctor before any procedure is performed. Recovery from a hysteroscopy is quick, and there’s generally no lasting effect beyond the first couple of days following the procedure.

CMS Id: 123831