Diagnostic and operative hysteroscopy

You may be a candidate for hysteroscopy if you have abnormal uterine bleeding — very heavy periods, bleeding between periods, or bleeding after menopause — if an ultrasound found polyps, fibroids, or another change inside the uterus, if you are having difficulty becoming pregnant, or if scar tissue or an IUD whose string is not visible needs to be removed. It can also be part of the workup for repeated miscarriages.

During your consultation, the specialist reviews your medical and gynecologic history, the medications you take, and prior studies such as a pelvic ultrasound. Hysteroscopy is not performed during pregnancy, and it is sometimes scheduled at a specific point in your menstrual cycle to get the clearest view of the uterus. Depending on your case, the specialists at Healthcare by the Sea will help you decide whether this is the right option for you.

Hysteroscopy is performed under anesthesia: this may be local anesthesia, sedation, or — in some cases — regional or general anesthesia, depending on whether the procedure is diagnostic or operative and on what your doctor recommends.

The specialist passes the hysteroscope through the vagina and cervix and gently expands the uterine cavity with a sterile fluid to see its walls clearly on a monitor. For a diagnostic procedure, the inside of the uterus and the openings of the fallopian tubes are examined, and a biopsy may be taken. For an operative hysteroscopy, very thin instruments are passed through the same scope to remove polyps, certain fibroids, or scar tissue during the same procedure.

Afterward, you rest in a recovery room under close observation by the medical team. As an outpatient procedure, most patients return home later the same day, with clear instructions and the attentive support of our team.

Everything starts with a consultation: the specialist reviews your medical and gynecologic history, performs an exam and often an ultrasound to plan the procedure, and talks with you about what may be found and treated.

Tell your doctor about all the medications and supplements you take; medicines that increase bleeding, such as blood thinners, should be paused only if your doctor instructs you to and with the timing they specify. If you smoke, stopping is a good idea, and if your procedure involves sedation or anesthesia you will receive fasting instructions that are important to follow exactly.

Arrange for someone to drive you home after the procedure, especially if you will receive sedation or anesthesia. Our team in Puerto Vallarta can help you coordinate these details — especially if you are traveling from another city or from the U.S. or Canada.

After hysteroscopy, it is normal to have mild cramping, similar to period cramps, and light spotting or bleeding for a few days. You may also notice brief shoulder discomfort if gas was used to expand the uterus. Taking it easy for the first day and using the pain reliever your doctor recommends is usually enough.

In many cases you can return to your usual activities within a day or two, though the timing depends on whether the procedure was purely diagnostic or included treatment. Your doctor may ask you to avoid intercourse, tampons, or douching for a short period while the uterus heals, and will tell you when to come back for follow-up and when biopsy results, if any, will be ready.

Go to the emergency room right away if you develop a high fever, heavy vaginal bleeding that does not stop, severe or worsening abdominal pain, or foul-smelling discharge, and notify the doctor who performed your procedure as soon as possible.

Medical reference source: Mayo Clinic.