"Hysteroscopy" is an outpatient surgical procedure that allows your doctor to look inside your uterus by passing a small telescope through the cervical canal. This procedure can be done at the same time as a laparoscopy in which case you will be under general anesthesia. If you are having a hysteroscopy without a laparoscopy, your doctor may recommend conscious sedation, which is deep anesthesia without the need for a ventilator to help you breath. You will not feel pain during the procedure. In order to see well inside the uterine cavity, it is necessary to distend the cavity of the uterus by infusing a clear solution through the hysteroscope. Small scissors, electrical cutting instruments and catheters can be placed through the hysteroscope to accomplish the necessary surgical procedures. Scar tissue inside the uterine cavity can be cut, and polyps and fibroids can be removed. If there is a wall (septum) dividing the uterine cavity in two, it can be cut or removed. When the fallopian tubes are blocked at the place where they are connected to the uterus, special catheters can be placed through the hysteroscope to attempt to re-open them.

You should have nothing to eat or drink after midnight before the surgery. If you have medicines that you have to take in the morning, you can usually do this with a small sip of water, but please discuss this with your doctor. You will need to be at the surgery center at the designated time. You should wear loose fitting clothing. Your doctor will meet with you before the surgery to discuss any last minute questions. You will go to the operating room and the anesthesiologist will put you to sleep. You will wake up in the recovery room and feel "groggy" and you may have some pelvic discomfort like menstrual cramps. You will be observed by the recovery room nurses until you are awake enough to walk on your own, can drink liquids without vomiting, and are able to urinate. The recovery room nurse will tell you when you can go home. Your doctor will have explained the surgical findings with a designated family member while you are waking up. Often, a picture from the surgery will be given to your family member. It is best to fully discuss the findings with you at a later date because the anesthesia will make you forget the conversation in the recovery room. A post-operative check-up and examination should be scheduled for 2 to 3 weeks after surgery, at which time the surgery will be discussed and a plan made for any future therapy.

In general you should be able to be "up and around" the day of surgery with some pelvic discomfort, and back to your usual activities within 1 to 4 days. You should take ibuprofen 600 mg every 6 hours for 2 days after surgery, and take a narcotic pain pill such as Percocet every 6 hours as necessary for additional pain relief. You may also have vaginal bleeding, but it should be less than a period. You may have some irritation when urinating because the bladder may have been catheterized to remove urine during the surgery. You may resume your usual activities and diet when you feel ready, and may resume intercourse one week after surgery.

Fortunately serious complications from hysteroscopy are very rare. After extensive hysteroscopic surgery such as removing fibroids, the fluid used to distend the uterine cavity can be absorbed by the body and lead to dilution of blood salts (electrolytes) or difficulty breathing. A perforation (hole through the wall of the uterus) could occur during hysteroscopy, but this usually heals quickly on its own without significant problems. Serious bleeding (hemorrhage) could occur if a major blood vessel is injured and may require a blood transfusion. Injury to the blood vessels, or internal organs could occur if the uterine wall is perforated and this may require a laparoscopy or laparotomy (an incision to open the abdomen) with other surgical procedures to repair the injury. These complications occur in 1/1000 procedures. Other rare complications could include blood clots in the blood vessels, pelvic organ infections, allergic reactions, damage to nerves in the arms or legs and anesthesia complications. You should call the office if you are concerned about any problems especially severe abdominal pain, nausea or vomiting, heavy vaginal bleeding (more than a period), or a temperature greater than 101 F.

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