Hysteroscopy

What is a hysteroscopy?
This is a procedure where a doctor uses a thin tube with a tiny camera to look
inside the uterus. There are no incisions. Saline solution is used to expand the
uterus in order to look at the inside of the uterus.

When is this surgery used?

The procedure allows us to see if there are any abnormalities in your uterus.
To evaluate and or treat diseases of the uterus
• Recurrent miscarriages
• Lost or retained IUD, will be removed if seen.
• Heavy or irregular vaginal bleeding, a scraping will be obtained.
• Inability to obtain an office endometrial sampling will be obtained.
• Sub mucosal fibroids, will be removed using electrical energy or cut out.
• Endometrial polyps will be removed using electrical energy or cut out.
• Scar tissue inside the uterus, will be cut out or use electrical energy to
remove.
• Permanent sterilization (Essure), the devices will be placed into the
opening of the fallopian tubes.

How do I prepare for surgery?

• Before surgery, a pre-op appointment will be scheduled with your doctor
at their office or with a nurse practitioner or physician assistant at
Domino Farms.
• Depending on your health, we may ask you to see your primary doctor, a
specialist, and/or an anesthesiologist to make sure you are healthy for
surgery.
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 • The lab work for your surgery must be done at least 3 days before
surgery.
• Some medications need to be stopped before the surgery. A list of
medications will be provided at your pre-operative appointment.
• Smoking can affect your surgery and recovery. Smokers may have
difficulty breathing during the surgery and tend to heal more slowly after
surgery. If you are a smoker, it is best to quit 6-8 weeks before surgery.
If you are unable to stop smoking before surgery, your doctor can order a
nicotine patch while you are in the hospital.
• You will be told at your pre-op visit whether you will need a bowel prep
for your surgery and if you do, what type you will use. The prep to clean
your bowel will have to be completed the night before your surgery.
• You will need to shower at home before surgery. Instructions will be
provided at your pre-operative appointment.
• Do not wear makeup, nail polish, lotion, deodorant, or antiperspirant on
the day of surgery.
• Remove all body piercings and acrylic nails.
• If you have a “Living Will” or an “Advance Directive”, bring a copy with
you to the hospital on the day of surgery.
• Plan for your care and recovery before surgery. Most women recover and
are back to most activities in 1-2 days.

What can I expect during the surgery?

• In the operating room, you will be given either a general anesthesia, or a
spinal anesthesia, or a local anesthesia. The choice of anesthesia is a
decision that will be made by the anesthesiologist based upon your
history and your wishes.
• If a general anesthesia is given, after you are asleep and before the
surgery starts:
o A tube to help you breathe will be placed in your throat.
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 o Another tube will be placed in your stomach to remove any gas or
other contents to reduce the likelihood of injury during the
surgery. The tube is usually removed before you wake up.
o A catheter will be inserted into your bladder to drain urine and to
monitor the amount of urine coming out during surgery.
• Compression stockings will be placed on your legs to prevent blood clots
in your legs and lungs during surgery.
• Your cervix will be dilated and then the hysteroscope is placed through
the cervix into the uterus. Fluid is instilled into the uterus for better
visualization.
• A dilation and curettage is often performed at the same time to remove
tissue for further testing.
• Photographs may be taken during the surgery and may be placed in your
medical records.

What are possible risks from this surgery?

Although there can be problems that result from surgery, we work very hard to
make sure it is as safe as possible. However, problems can occur, even when
things go as planned. You should be aware of these possible problems, how
often they happen, and what will be done to correct them.

Possible risks during surgery include:

• Bleeding: If there is excessive bleeding, you will be given a blood
transfusion unless you have personal or religious reasons for not wanting
blood. This should be discussed with your doctor prior to the surgery.
• Damage to the bladder, ureters (the tubes that drain the kidneys into the
bladder), uterus, and to the bowel: Damage occurs in less than 1% of
surgeries. If there is damage to the bladder, ureters, uterus, or to the
bowel they will be repaired while you are in surgery.

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 • Conversion to a laparoscopic surgery or to an open surgery requiring
an up and down or Bikini incision: If a bigger open incision is needed
during your surgery, you may need to stay in the hospital for one or two
nights.
• Death: All surgeries have a risk of death. Some surgeries have a higher
risk than others.

Possible risks that can occur days to weeks after surgery:

• A blood clot in the legs or lung: Swelling or pain, shortness of breath, or
chest pain are signs of blood clots. Call you doctor immediately if any of
these occur.
• Bowel obstruction: A block in the bowel that results in not being able to
pass stool or gas. May cause stomach pain, bloating or vomiting.
• Infection: Fever, redness, swelling or pain at the site of surgery.
• Scar tissue: Tissue thicker than normal skin forms at the cervix or uterus.

What happens after the surgery?

• You will be taken to the recovery room and monitored for a short time
before going home.
• You will be given medications for pain and nausea.
• You will have the compression stockings on your legs to improve
circulation.
• You may have some vaginal spotting of bright red, brown, or black
discharge.
• You may have a scratchy throat if a general anesthesic was used.
• You will start walking as soon as possible after the surgery to help
healing and recovery.

When will I go home after surgery?

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Most women are able to go home the same day the surgery is done. You must
arrange for someone to come with you, stay while you are having surgery and
drive you home afterwards.

If you do not know someone who can do this, please call the Guest Assistance
Program at: (734)764-6893 or (800)888-9825.

You will not be able to have your surgery if there is no-one with you.

At home after surgery:

Call your doctor right away if you:
• develop a fever over 100.4°F (38°C)
• start bleeding like a menstrual period or (and) are changing a pad
every hour
• have severe pain in your abdomen or pelvis that the pain medication
is not helping
• have heavy vaginal discharge with a bad odor
• have nausea and vomiting
• have chest pain or difficulty breathing
• develop swelling, redness, or pain in your legs
• develop a rash
• have pain with urination

Other Symptoms:
• Vaginal Bleeding: You may have some vaginal spotting of watery bright red,
brown, or black discharge for up to 3-4 weeks. You may have abdominal
cramping for 48 hours.
• Diet: You will continue with your regular diet.

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• Medications:
• Pain: Medication for pain will be prescribed for you after surgery. Do not
take it more frequently than instructed.
• Nausea: Anti-nausea medication is not typically prescribed. Tell your doctor
if you have a history of severe nausea with general anesthesia.

Activities:
• Energy level: It is normal to have a decreased energy level after surgery.
After you are home, you should minimize any strenuous activity for the first
day or two. It is important not to overdo, but once you settle into a normal
routine at home, you will find that you slowly begin to feel better. Walking
around the house and taking short walks outside can help you get back to
your normal energy level more quickly.
• Showers: Showers are allowed within 24 hours after your surgery. Do not
take baths for at least 1 week after surgery.
• Climbing: Climbing stairs is permitted, but you may require some assistance
initially.
• Lifting: For 1-2 days after your surgery you should not lift anything heavier
than a gallon of milk. This includes pushing objects such as a vacuum
cleaner and vigorous exercise.
• Driving: The reason you are asked not to drive after surgery is because you
may be prescribed medications. You should not drive or operate heavy
machinery for 24 hours after surgery.
• Exercise: Exercise is important for a healthy lifestyle. You may begin
normal physical activity within hours of surgery. Start with short walks and
gradually increase the distance and length of time that you walk.
To allow your body time to heal, you should not return to a more difficult
exercise routine until 2 days after your surgery. Please talk to your doctor
about when you can begin exercising again.
• Intercourse: No sexual activity for 2 weeks after surgery.
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 • Work: Most patients can return to work between 1-2 days after surgery.
You may continue to feel tired for a couple of weeks.

Follow-up with your doctor:

You should have a post-operative appointment scheduled with your doctor for
4-6 weeks after surgery.

If you have any further questions or concerns about getting ready for
surgery, the surgery itself, or after the surgery, please talk with your doctor.

Disclaimer: This document contains information and/or instructional materials developed by

the University of Michigan Health System (UMHS) for the typical patient with your condition.
It may include links to online content that was not created by UMHS and for which UMHS
does not assume responsibility. It does not replace medical advice from your health care
provider because your experience may differ from that of the typical patient. Talk to your
health care provider if you have any questions about this document, your condition or your
treatment plan.

Author: Laurie Crimando RNC,MSN

Reviewers: K., Wang, MD, Diana Stenton PA

Patient Education by University of Michigan Health System is licensed under a Creative Commons
Attribution-NonCommercial-ShareAlike 3.0 Unported License. Last Revised 4/8/2015

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