Therapeutic Hysteroscopy for Endometrial Ablation



Diagnostic Hysteroscopy with Biopsy

What is a hysteroscopy?

A hysteroscopy is a procedure in which the doctor uses a hysteroscope to look at the inside of your uterus. A hysteroscope is a thin tube with a tiny camera. The uterus is the muscular organ at the top of the vagina. Babies develop in the uterus, and menstrual blood comes from the uterus. The doctor can guide a tool into the uterus to remove the uterine lining.

When is it used?

This procedure may be performed when you have consistent bleeding from the uterus even after trying other treatments to control it. You may have too much growth in the lining of your uterus, or your ovaries may not be working well. The procedure might be used to evaluate infertility, bleeding after menopause, help retrieve an IUD, evaluation of uterine anomalies, etc. It is also used to evaluate the uterus in order to plan for other procedures such as an endometrial ablation or sterilization.

Examples of alternatives to this procedure are:

• Hormone therapy such as oral contraceptives

• Having a D&C (dilation and curettage), in which the doctor opens the cervix and scrapes or suctions tissue from the uterus

• Choosing not to have treatment, recognizing the risks of your condition.

You should ask your doctor about these choices.

How do I prepare for diagnostic hysteroscopy?

The procedure can be done in the office at which time no special preparation is required.

Follow instructions provided by your doctor. If you are to have the procedure done in the hospital, eat a light meal, such as soup or salad, the night before the procedure. Do not eat or drink anything after midnight and the morning before the procedure. Do not even drink coffee, tea, or water.

What happens during the procedure?

You are given a local anesthesia or IV sedation or sometimes general anesthesia if done in a hospital. A local anesthesia numbs part of your body while you remain awake. Local anesthesia keeps you from feeling pain during the procedure. A general anesthetic relaxes your muscles, puts you to sleep, and prevents you from feeling pain.

The doctor dilates (opens) your cervix. The doctor guides a hysteroscope through the cervix into the uterus. The uterus is then inflated with fluid. This allows the doctor to look at the inside of your uterus more closely. The doctor might then insert a small instrument to retrieve tissue for a biopsy of the uterus.

What happens after the procedure?

If done in the office, you will sit for a few minutes after the procedure and you will then go home. Plan to have somebody with you to drive you home as you may have received some medication prior to the procedure.

If the procedure is done in the hospital, you may stay in the hospital for a few hours.

After the procedure you may:

• feel sleepy or groggy from the anesthetic

• have some cramps

• have some mild bleeding

If you have concerns about this, discuss them with your doctor.

Ask your doctor what steps you should take and when you should come back for a checkup.

What are the benefits of this procedure?

What are the risks associated with this procedure?

• There are some risks when you have general anesthesia. Discuss these risks with your doctor.

• You may have infection or bleeding

• Rarely, the uterus could be punctured and need surgery to repair it.

• The bowel or bladder may be injured.

You should ask your doctor how these risks apply to you.

When should I call the doctor?

Call the doctor immediately if:

• You start to bleed a lot (like a menstrual period).

• You develop a fever

• You have a lot of pain in your lower abdomen

Call the doctor during office hours if:

• You have questions about the procedure or its results

• You want to make another appointment

This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.

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