Hysteroscopy: Indications, Preparation & Procedure

About Hysteroscopy
Hysteroscopy examines the uterine cavity (endometrium) with a flexible video system — a hysteroscope — inserted through the vagina and cervix. The lighted camera projects the view onto a screen. It is performed for diagnostic and therapeutic purposes.

Indications:

• Irregular or heavy menstruation (hypermenorrhea/menorrhagia)

• Female infertility evaluation

• Removal of fibroids, scars, polyps, and other lesions

• Correction of endometrial anomalies

• Removal of retained placental tissue postpartum

• Insertion of contraceptives (IUD, implant)

• Assessment of fallopian tube patency

A small biopsy sample may be taken during the exam.

Contraindications:

• Active infections/inflammation of the vagina, cervix, or uterus

• Severe systemic disease or unstable general condition

• Large cervical masses or cervical stenosis

• Ongoing pregnancy

• Heavy uterine bleeding

• Not recommended for girls under 15 years

Preparation:

• Ideally scheduled 3–5 days after menstruation.

• One week prior: stop local meds/contraceptives/intimate gels; two days prior: abstain from intercourse.

• If lesion removal is planned, brief hospitalization may be needed; purely diagnostic exams often require no anesthesia.

Aftercare:

• Avoid tampons; use sanitary pads

• No intercourse for 3 days

• Avoid sauna/hammam and hot baths

Possible (rare, ~1%) complications:

• Uterine perforation, bleeding

• Infection or flare of chronic pelvic disease

• Air embolism with gas hysteroscopy

• Allergic or anesthetic reactions

Procedure flow:

• For planned procedures: blood/urine/vaginal swabs, chest X-ray, ECG; anesthesia type chosen; performed fasting.

• Ambulatory hysteroscopy is acceptable only if immediate hospital transfer is available.

• The uterus is distended with gas or fluid; a ~5 mm hysteroscope is inserted.

• Mild cramps and light spotting may persist for 2–3 days.

Hysteroscopy is generally safe; accuracy and low risk depend on an experienced specialist.

Author: Saidə Əlixanova, Obstetrician-Gynecologist, SƏHHƏT Clinic