THEhysteroscopy is an exam that allows you to visualize theinside the uterus, thanks to the introduction of a hysteroscope (tube fitted with an optical device) in the vagina then through the cervix, up to the uterine cavity. The doctor will be able to observe the opening of the cervix, the interior of the cavity, the “mouths” of the fallopian tubes.

This procedure is used to make a diagnosis (diagnostic hysteroscopy) or to treat a problem (surgical hysteroscopy).

The hysteroscope is a medical optical instrument made up of a light source and an optical fiber. It is often equipped with a mini-camera at the end and connected to a screen. The hysteroscope can be rigid (for surgical hysteroscopy) or flexible (for diagnostic hysteroscopy).

Hysteroscopy can be performed in the following cases:

• bleeding that is abnormal, too heavy or between periods

• irregular menstrual cycle

• severe cramps

• following multiple miscarriages

• difficulty getting pregnant (infertility)

• to screen for cancer of the endometrium (lining of the uterus)
• to diagnose a fibroid

Hysteroscopy can also be performed to perform samples or small surgical procedures:

• removal of polyps or fibroids

• section of a uterine septum

• release of joints between the walls of the uterus (synechiae)

• or even removal of the entire uterine lining (endometrectomy).

Depending on the procedure, the doctor performs general or locoregional anesthesia (surgical hysteroscopy) or only local anesthesia or even no anesthesia (diagnostic hysteroscopy).

He then places a vaginal speculum and inserts the hysteroscope (3 to 5 mm in diameter) into the opening of the cervix, then progresses until it reaches the uterine cavity. Physiological liquid (or gas) is injected beforehand, in order to unfold the walls of the cervix and inflate the uterine cavity to make them more visible.

The doctor can take samples of tissue fragments or perform small surgical procedures. In the case of an operative hysteroscopy, the cervix is ​​dilated beforehand to allow the introduction of surgical instruments.

Hysteroscopy allows the doctor to precisely visualize the interior of the uterine cavity and to detect any abnormalities there. He will suggest appropriate treatments based on what he observes.

In case of samples, he will have to analyze the tissues before being able to establish a diagnosis and propose a treatment.