Hysteroscopy for Abnormal Vaginal Bleeding
A hysteroscope is a small metal tube connected to a light source and camera. It magnifies the cervical opening, uterine cavity, and the openings of the fallopian tubes during a procedure called hysteroscopy.
Hysteroscopy may be:
diagnostic, in which case it is only used to view the organs and observe any obvious abnormalities
therapeutic, in which case surgery is done through the scope
It can be:
used to evaluate abnormal vaginal bleeding
combined with dilatation and curettage (D & C) or laparoscopy
Who is a candidate for the procedure?
A hysteroscopy may be recommended:
if the source of bleeding is not found through a D & C
to aid in taking a biopsy, or tissue sample, from the lining of a woman's uterus after precancerous changes have been noted
to check the upper part of the cervix to see if a cancer stems from the cervix or the uterus
if a woman's medical history or a test suggests she has a uterine polyp or fibroid that might be removed by hysteroscopy
How is the procedure performed?
A hysteroscopy is usually done in the first 2 weeks of a woman's menstrual cycle. This ensures she is not pregnant. It takes about 20 to 45 minutes and can be done:
in an office under local anesthesia
in the hospital under general anesthesia if combined with a D & C or laparoscopy
First, the cervix and vagina are cleansed. The cervix is opened so that the scope can be inserted into the uterus. The uterus is inflated with fluid or a harmless gas to make it easier to view.
Any suspicious lesions (polyps, fibroids, ulcers, or growths) may be biopsied or removed using small tools placed in the scope. This tissue is sent for microscopic analysis. Pictures may be taken, too, before and after any surgery is done.