A doctor performs a hysteroscopy to look at the inside of your uterus. There are several situations in which you may need this procedure. This includes confirming a diagnosis of a condition or disease, preparing for a dilation and curettage (D&C), or removing benign growths from the uterus
During a hysteroscopy, your doctor inserts a tool called a speculum into the vagina to visualize and dilate the cervix. Then they insert a tube with a light and camera called a hysteroscope through the cervix to see and take pictures inside the uterus.
For most diagnostic-only purposes, the hysteroscopy can be done in your doctor’s office with local or regional anesthesia.
When hysteroscopy is used in conjunction with a more in-depth surgical procedure, you’ll have it done in a hospital. In that case, the doctor will use regional or general anesthesia, depending on the extent of the surgery that you need.
Reasons to do a hysteroscopy include:
- for visual confirmation of another test result
- to look for the cause of an atypical or excessively heavy period or of pelvic pain
- to aid in the removal of fibroids and polyps
- to aid in removing ab intrauterine device (IUD)
- in conjunction with a laparoscopic procedure
- prior to a D&C procedure
- to discover any malformation of the uterus
Your primary doctor may refer you to a specialist for this procedure.
The procedure will take place with you in the same position as you’re normally in for a gynecological exam, with your feet in the stirrups at the end of the exam table. It may take anywhere between 5-30 minutes, depending on why it is being done.
During a hysteroscopy:
- The doctor will first insert the speculum into the vagina. This is also like what happens during a gynecological exam.
- The doctor will then insert the hysteroscopy device through the cervix. They will continue moving it through the cervix and then into the uterus.
- A liquid or carbon dioxide gas will then be gently sent into your uterus through the device to clear the surface and to help widen it slightly.
- The light and camera on the end of the hysteroscope allow the doctor to see the uterus and fallopian tubes. This allows them to diagnose any issues or perform any necessary surgical procedures.
If the procedure is being used for surgery, the surgical devices will also be put through the hysteroscope tube to perform the surgery.
The purpose of the hysteroscopy will determine the length of recovery. However, there are some general things that are common after any hysteroscopy procedure. You may experience the following:
- slight bleeding or spotting for a day or so
- shoulder pain (if carbon dioxide gas was used)
- mild nausea
- lightheadedness or dizziness
Supportive care can help relieve these side effects if they occur. But if you still experience them a week after the procedure, you should see your doctor. You’ll be able to eat or drink immediately following the hysteroscopy.
How long is recovery after a hysteroscopy?
If you have your procedure in the doctor’s office with just local anesthesia, you’ll typically be able to leave in less than an hour.
If your procedure requires regional anesthesia, your doctor may want you to wait until the effects have worn off before sending you home. This may also take less than an hour, but it could take longer depending on how much anesthesia is used.
If your procedure requires general anesthesia, it’s still outpatient. You’ll be able to return home after a few hours. Your doctor will only require an overnight stay in the hospital for observation if you have had a past reaction to anesthesia.
If surgery is involved, your doctor may have you rest for a day or two before resuming your usual schedule. Follow your doctor’s instructions for recovery. For a hysteroscopy that isn’t purely diagnostic, you should refrain from sexual activity for about a week. This helps reduce the chance of infection.
The procedure itself shouldn’t be painful. However, you may experience some cramping.
Your doctor may order some sedatives for you to take beforehand to help you feel more relaxed. The extent of anesthesia you need will depend on the purpose of your hysteroscopy. It’ll also depend on where you have your hysteroscopy. It can be done in your doctor’s office or hospital.
After the procedure, your doctor may prescribe pain medication to make recovery easier.
In the United States, the total cost of hysteroscopy varies between $2800 and $4800.
The cost varies based on the reason for the procedure and what other testing or procedures the doctor may also need to do. For instance, a diagnostic-only procedure is much less than one involving surgery. The cost may be higher if you have a more extensive procedure, including hospital surgery and general anesthesia.
The cost may also depend on whether it is done in an ambulatory surgical center or a hospital outpatient department.
The amount a person pays out-of-pocket will also depend on whether or not they have Medicare or private health insurance. Some health insurance carriers will cover a hysteroscopy, at least partially, when it’s considered medically necessary. Coverage varies from policy to policy, so talk with your insurance carrier to determine your out-of-pocket costs.
A hysteroscopy is considered a fairly safe procedure with minimal complications. However, it’s still considered surgery. Because of this, there are some possible complications, though they are not common. They
- scarring of the uterus
- heavy bleeding
- a reaction to anesthesia or the liquid used to clean the uterus
- any side effects associated with the use of anesthesia
You should contact your doctor immediately if you experience any of the following:
- heavy bleeding
- severe pain
Your doctor may suggest a hysteroscopy for several different reasons. These situations require a closer look or minor surgery for your long-term health and well-being. If you have questions, be open and honest with your doctor. Ask any questions that you need to.
The risks with a hysteroscopy are extremely low but should still be discussed with your doctor before any procedure is performed. Recovery from a hysteroscopy is quick, and there’s generally no lasting effect beyond the first couple of days following the procedure.