Flexible Office Hysteroscopy

What is flexible office hysteroscopy? Office hysteroscopy is a way of viewing the inside of the uterus by gently inserting a very thin, flexible fiber-optic camera, called a hysteroscope, into the uterus through the vagina. An office hysteroscopy takes place in your doctor's office, instead of under general anesthesia in the operating room. This allows your doctor to identify any problems that may be originating in the uterus much more accurately than with a D&C. It is done without making incisions and with little discomfort. While the insertion portion of the hysteroscope itself is very thin (thinner than the diameter of a pencil), the advanced optic design allows a full color view of the inside of the uterus and the openings to the Fallopian tubes. If your doctor has a video monitor in the room, you will be able to see as well and have your questions answered.

Why would I need flexible office hysteroscopy? You may be experiencing abnormal uterine bleeding, or AUB, often due to fibroids or polyps in the uterus. AUB can be defined as any significant change in your period. Maybe you've noticed an increase in your flow, or more frequent periods or unexplained spotting or bleeding after menopause. Rather than putting you under general anesthesia just for a diagnostic procedure, your doctor may prefer an immediate diagnosis in the office. Based on what your doctor finds, you can discuss what method of treatment is best for you—right then and there. Another reason your doctor might suggest an office hysteroscopy is if you have trouble conceiving or suffer from repeated miscarriages. Your doctor might prefer an office hysteroscopy in order to actually see—rather than make an educated guess—if you have adhesions, polyps or fibroids that may be hindering conception or carrying a pregnancy to term. And the more you and your doctor know about what the problem is, the easier it is to treat.

What happens to me during flexible office hysteroscopy? You'll change into a gown and lie on an examination table with your feet in stirrups. Your doctor will check to see if the opening of the cervix needs to be dilated slightly with a special instrument. The hysteroscope is then gently inserted through the vagina and cervix into the uterus. Your doctor will release a small amount of saline solution into the uterine cavity, allowing it to expand so he or she can see more clearly. A light in the hysteroscope allows your doctor to carefully check the walls of the uterus and the openings of the fallopian tubes. The examination takes less than 10 minutes.

Does the procedure hurt? It causes little discomfort. Most women only feel a minor pinch or very mild cramping, similar to menstrual cramping.

Are there any side effects from the procedure? You may experience menstrual-type cramps and slight bleeding for about 24 hours after a hysteroscopy. Office hysteroscopy is a very safe procedure because it is done under constant visualization. Complications are rare. Instances of infection, heavy bleeding, injury to the cervix or uterus occur in less than 1% of cases. Should you experience severe abdominal pain, heavy vaginal bleeding or discharge or a fever, get in touch with your doctor. Feel free to discuss office hysteroscopy with your doctor as a patient-friendly option for diagnosis of abnormal uterine bleeding, certain types of infertility and other gynecological problems.