Hysteroscopy is seeing inside the uterus using a hysteroscope, a thin telescope that is inserted through the cervix into the uterus.  Modern hysteroscopes are so thin that in most cases cervix is not to be dilated.  Inside of the uterus being a potential cavity, it is necessary to fill (distend) it with either a liquid or a gas (carbon dioxide) in order to see.  Diagnostic hysteroscopy and simple operative hysteroscopy can usually be done in an office setting.   More complex operative hysteroscopy procedures are done in hospitals.


Unless a woman has major medical problems, it is an office procedure.   After anaethetising the cervix, the hysteroscope is inserted into the uterus under direct vision while using either saline or carbon dioxide to fill the uterus.  This Usually causes mild cramps.  A gynecologist then looks for fibroids, polyps and other problems that may be causing bleeding.  This often takes about a minute or two.  The hysteroscope is removed.  A small bit of the lining of the uterus may be taken for analysis.


During diagnostic hysteroscopy the hysteroscope is used just to observe the endometrial cavity. During operative hysteroscopy a hysteroscope that has channels, through which it is possible to insert very thin instruments, is used. These instruments can be used to remove polyps and to perform other procedures. With the development of better and smaller instruments, it is now possible to remove some polyps in addition to doing other procedures that used to require a full operating room. In many situations, operative hysteroscopy may offer an alternative to hysterectomy.