Diagnostic Hysteroscopy

Who should have a diagnostic hysteroscopy?

Most women with menstrual disorders will not require a diagnostic hysteroscopy. However, a diagnostic hysteroscopy is often necessary for women who develop menstrual abnormalities after the age of 40 or for younger women with severe menstrual disturbances. Here are some of the common situations in which a diagnostic hysteroscopy may be helpful.

Hysteroscopic Examination of the Uterus Diagram
Hysteroscopic images comparing a normal uterus to a uterus with a large polyp to a uterus divided by septum to a uterus with a fibroid.
  • Women who develop a menstrual abnormality who are over 40 years of age.
  • Women with irregular menses who may be at increased risk for endometrial
  • Women with suspected endometrial polyps.
  • Women with suspected uterine fibroids.
  • Women who experience postmenopausal bleeding.
  • Postmenopausal women with an abnormally thickened uterine lining.
  • Women in whom a congenital abnormality is suspected.
  • Women who have “lost” IUDs—where the IUD strings are no longer visible on speculum

Frequently asked questions about diagnostic hysteroscopy

  1. Where do you perform diagnostic hysteroscopy? Hysteroscopies are performed in our office-based operating room.
  2. Is diagnostic hysteroscopy painful? No. We perform most of our diagnostic hysteroscopies with intravenous sedation.
  3. Who administers intravenous sedation? Intravenous sedation may be administered by one of our anesthesiologists or by Dr. Wortman himself.
  4. How many diagnostic hysteroscopies have Dr. Wortman performed? Dr. Wortman performed over 4000 diagnostic hysteroscopies.
  5. What other tests are done at the time of hysteroscopy? Often a diagnostic hysteroscopy is combined with an endometrial biopsy which involves the removal of a small tissue sample that can be sent to the lab for analysis. At other times an endometrial polyp may be removed.
  6. What are the risks of diagnostic hysteroscopy? The risks of diagnostic hysteroscopy are quite
    few. The incidence of uterine perforation is approximately 1 in 2,000 cases. Infection is very rare following diagnostic hysteroscopy. On rare occasions we are unable to gain access to the uterine cavity. This occurs approximately 1 in 500 cases as is likely the most common
    complication we experience.
  7. When will I know about my test results from the endometrial biopsy? We will generally have your test results within a week of your procedure.
  8. Will there be a follow-up appointment to discuss the results of my diagnostic hysteroscopy? Yes. A follow-up appointment will be scheduled within 2 weeks of your diagnostic procedure. During your follow-up appointment we’ll discuss your treatment plan.
  9. Do I have to be sedated for a diagnostic hysteroscopy? No. Most women, however, choose to have intravenous sedation as the procedure can be painful. However, you can discuss this issue with Dr. Wortman.
  10. Is the Center for Menstrual Disorders an accredited facility? Yes. We are accredited every 3 years and operate under the auspices of the Accreditation Association for Ambulatory Health Care (AAAHC).

Postoperative Instructions

  1. Get as much rest as you need. You will likely feel sleepy for several hours following your procedure. You may even experience nausea; but it shouldn’t last long.
  2. You may eat whenever you are comfortable.
  3. Vaginal bleeding is normal and may last a few days following your procedure. It will taper off to a brownish vaginal discharge. Don’t be concerned if you don’t experience bleeding.
  4. You may shower or bathe whenever you wish.
  5. You may resume sexual relations whenever you wish
  6. You may use tampons or pads—as you prefer.
  7. Under no circumstances should you drive or operate dangerous machinery for 12 hours following your procedure is you receive intravenous sedation.