Hysteroscopy refers to passing a camera through the cervix to examine the uterus from the inside. Although many patients are nervous about this when they are told that they will need a hysteroscopy, most are relieved and surprised at the end to find that the procedure is much shorter and less difficult than they expected.
The hysteroscopy is done in office under sterile technique, and takes about ten minutes. We recommend that the patient take ibuprofen about an hour before, as there is cramping like a heavy menstrual period during the procedure. Local anesthetic is also given to help with the cramping. The camera itself is thin–about the same thickness as a pencil. Using this, the doctor is able to examine the cervix, the openings of the fallopian tubes, and the body of the uterus. This is valuable because it can help evaluate scarring, fibroids, tumors, and other potential sources of abnormal bleeding or pain. One of the key reasons this is done is to help rule out cancer of the uterus. After the doctor examines the uterus by camera, the camera is taken out and a biopsy is taken. This does cause cramping but takes less than ten seconds. After the hysteroscopy and biopsy are taken, the cramping diminishes in just a few minutes.
The patient should expect spotting for a few days after the hysteroscopy, and should abstain from sex until after the spotting stops.