Hysteroscopy: What it is, preparation, pain and care

If you have been prescribed a hysteroscopy, it is normal for doubts or some concern to arise regarding the unknown: Is it a painful test? Will I need medical leave? Will it affect my fertility?

This procedure is one of the most valuable tools in current gynecology because it allows, at the same time, to diagnose and resolve uterine problems in a minimally invasive way.

In this guide we explain step by step how to preparethe key differences between doing it in consultation or the operating room and what to expect during your recovery, so that you go to your appointment informed and calm. We want to thank the Dr. Concepción de Lucas Ortegaspecialist in Gynecology and Obstetrics in Viacare Medical Centeryour collaboration in the review of this content to guarantee maximum quality and medical rigor.

What is hysteroscopy? Definition and technique

The hysteroscopy It is a procedure that allows see inside the uterus using a very fine camera called hysteroscope. Through the cervix, without incisions, the specialist introduces the instrument and distends the cavity with serum (or CO₂) to get a direct view of the endometrium and tubal orifices.

Its great advantage is that diagnose andin many casestreats in the same act, problems that affect the uterine cavity, with a rapid recovery and, usually, on an outpatient basis.

When is it done? Indications: Polyps, Fibroids and Fertility

The indication is individual, but hysteroscopy is especially useful when alterations within the uterus are suspected or when there are symptoms that suggest it. Among the most frequent situations:

• Abnormal uterine bleeding (between periods, very abundant or postmenopause).
• Endometrial polyps and submucosal fibroids.
• Suspected uterine malformations (e.g., uterine septum).
• Retention of remains after abortion or childbirth.
• Infertility/sterility: cavity assessment and detection of synechiae (adhesions).
• foreign bodies inside the uterus (e.g. interlocked IUD).
• Need for targeted biopsy when ultrasound shows a finding that requires confirmation.

Differences between Diagnostic and Surgical Hysteroscopy (Operative)

Although the basic technique is the same, it is worth distinguishing two scenarios:

Diagnostic hysteroscopy

It is usually done in consultationwith small caliber instruments and without the need for general anesthesia. Serves for explore the uterine cavity, take biopsies if necessary and plan the treatment. The discharge is immediate.

Surgical hysteroscopy (operative)

Indicated when, in addition to looking, you have to treat: resect a submucosal polyp or fibroid, release synechiae, correct a uterine septum or remove a complicated IUD. It is usually carried out in operating roomwith sedation or anesthesiaand requires subsequent control somewhat closer than diagnosis.

Step by step procedure: How is the test done?

The procedure is adapted to each case, but the general flow is simple.

In consultation (diagnosis)

1. Gynecological position.
2. Introduction of the hysteroscope through the cervix (sometimes without a speculum, depending on technique).
3. Distension of the cavity with serum to improve vision.
4. Systematic inspection of the endometrium and tubal orifices; are taken biopsies if applicable.
5. Initial explanation of the finding and high.
   Indicative duration: 10–20 minutes.

In the operating room (surgical/operative)

1. Preparation and sedation/anesthesia for your comfort.
2. Introduction of the hysteroscope and therapeutic gesture planned (e.g., polyp/fibroid resection with specific devices, lysis of synechiaeseptum correction).
3. Hemostatic control and discharge to brief resuscitation.
   Indicative duration: 20–60+ minutes depending on the case.

Does hysteroscopy hurt? Anesthesia and tolerance

The perception of pain varies, but in most patients the diagnostic hysteroscopy is well tolerated.

• In consultationit can be noticed colicky discomfort during distension and when passing the cervix; take a analgesic sooner can help.
• In operationthe sedation or anesthesia guarantees comfort. After the procedure, it is common to period pain mild, controllable with regular medication.

Previous preparation: Fasting, menstrual cycle and care

Simple preparation improves test quality and your comfort:

• Schedule it out of heavy menstruation (unless urgent or otherwise indicated).
• Avoid sexual intercourse, tampons and douching 24–48 hours before.
• Notify if there is possibility of pregnancy (it is a contraindication).
• Inform about anticoagulants/antiplateletsallergies and relevant pathologies.
• Carry previous tests (ultrasounds, analytics, reports).
• If there will be sedationgo in fasting according to the center’s protocol.

Results and report: What does the biopsy detect?

At the end, the team will clearly explain what was observed and the next steps. He report usually includes:

• Description of the cavity and possible injuries (sometimes with images).
• Biopsies carried out, if applicable, and the circuit to know its result.
• Treatments performed (if it was an operation) and recommendations.
• Monitoring plan (controls, repetition of tests, review consultation).

The results of Pathological Anatomy, when there are biopsies, are communicated in the term that indicates your center.

Risks and side effects: Bleeding and complications

Hysteroscopy is a technique safe in expert hands, but like any medical procedure it can lead to unwanted effects.

Expected and uncommon effects

• Colic-type discomfort for hours.
• Stained vaginal 24–72 hours (somewhat longer if a therapeutic gesture was performed).
• Episodes vasovagales (dizziness) self-limited.

Uncommon complications

• Infection
• Bleeding
• Uterine perforation (more associated with operative hysteroscopy).
• Reactions to the sedation/anesthesia if used.

Contraindications

• Pregnancy.
• Pelvic inflammatory disease
• Profuse bleeding that prevents viewing (may require rescheduling).

Go to the emergency room if you present heavy bleeding, fever, intense pain that does not yield or bad smell vaginal.

Recovery after hysteroscopy and aftercare

In most cases, recovery is fast and you can resume your activity usual in a short time.

• Same day discharge.
• If there was a biopsy or treatment, avoid sexual intercourse, tampons and douching during 48 hours (or the time indicated by your specialist).
• For him period painuse the pain relievers scheduled.
• Use compress if there is staining (better than a tampon).

Hysteroscopy and Pregnancy: Benefits for fertility

Hysteroscopy has an important role in fertility studybecause it allows discard and treat alterations that make implantation difficult or increase the risk of complications:

• Endometrial polyps, submucosal fibroids and synechiae can affect the endometrial receptivity; his correction hysteroscopic improves the cavity environment.
• After certain procedures, the team will guide you on when to resume the search for pregnancywhich will depend on the intervention performed and your clinical situation.

Comparison: Hysteroscopy vs. Ultrasound and Curettage

• Transvaginal ultrasound: is the first line to assess the uterus; hysteroscopy adds direct vision and possibility of treat.
• Sonohysterography– Infuses serum during ultrasound to outline the cavity; helps decide if hysteroscopy is needed, but does not treat.
• Hysterosalpingography (HSG): radiology with contrast to assess tubal patency; It is complemented with hysteroscopy when it is interesting to see/treat the uterine cavity.
• Curettage: “blind” technique; hysteroscopy is guided by visionso it turns out more precise and conservative.

Hysteroscopy is a technique minimally invasiveprecise and versatile that allows diagnose and, when needed, treat alterations inside the uterus with quick recovery. Go to the test well informed helps to live it calmly and then continue the monitoring plan or treatment indicated by the medical team.

In Viamed We have specialists in Gynecology with extensive experience in diagnostic and surgical hysteroscopy. If you need to resolve questions or schedule your procedure, make your appointment.