Hysteroscopy

WHAT YOU SHOULD KNOW:

• A hysteroscopy is a type of surgery done to look at the inside of your uterus. The uterus is a pear-shaped organ in your abdomen (belly) where a baby grows when you are pregnant. You may need a hysteroscopy if you are having trouble getting pregnant, or have lost babies while pregnant. It may also be done to check or remove fibroids, cancer, or polyps . A fibroid is a harmless tumor of the uterus. A polyp is a lump of tissue on the inside of the uterus. It may be done to open your fallopian tubes, or remove adhesions (scars) inside your uterus. A hysteroscopy may also be done to find the cause of abnormal bleeding, or check your IUD. An IUD is an intrauterine device which helps prevent pregnancy.
  
  
• Other procedures may also be done when you have a hysteroscopy. You may have a dilation and curettage procedure, also known as a D&C. This procedure is done to remove the inner lining of your uterus. Another procedure called a laparoscopy may be done at the same time as the hysteroscopy. It is done to look inside your abdomen. After surgery, you may need to stay in the hospital overnight, or you may be able to go home the same day.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

There are risks with the hysteroscopy procedure. You may have abdominal cramping, and you may bleed too much. The procedure may scar your uterus and cause problems later. You may develop blood clots, or an infection . You may have a reaction to the medicines used to fill your uterus during the hysteroscopy. You may have a reaction to the anesthesia. You may have trouble breathing, or a perforated (punctured) uterus, bowel, or bladder. If you do not have surgery, caregivers may not be able to tell what is causing your problems. Call you caregiver if you are worried or have questions about your medicine or care.

WHILE YOU ARE HERE:

• Call button: You may use the call button when you need your caregiver. Pain, trouble breathing, or wanting to get out of bed are good reasons to call. The call button should always be close enough for you to reach it.
  
  
• Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.
  
  
• Chest x-ray: This is a picture of your lungs and heart. Caregivers use it to see how your lungs and heart are doing. Caregivers may use the x-ray to look for signs of infection like pneumonia, or to look for collapsed lungs. Chest x-rays may show tumors, broken ribs, or fluid around the heart and lungs.
  
  
• Heart monitor: This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.
  
  
• An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.
  
  
• Pregnancy Test: This is a urine or blood test done to check if you are pregnant. This procedure may be dangerous to an unborn baby.
  
  
• Pulse oximeter: A pulse oximeter is a device that measures the amount of oxygen in your blood. A cord with a clip or sticky strip is placed on your finger, ear, or toe. The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your oxygen level is low or cannot be read.
  
  
• Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.
  
  
• Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.
  
  
• Anesthesia: This medicine is given to make you comfortable. You may not feel discomfort, pressure, or pain. An adult will need to drive you home and should stay with you for 24 hours. Ask your caregiver if you can drive or use machinery within 24 hours. Also ask if and when you can drink alcohol or use over-the-counter medicine. You may not want to make important decisions until 24 hours have passed.
  
  
  • General anesthesia: Caregivers use this medicine to keep you asleep and free from pain during surgery. They give you anesthesia through your IV or as a gas. You may breathe in the gas through a mask or through a breathing tube placed down your throat. The tube may cause you to have a sore throat when you wake up.
    
    
  • Regional anesthesia: Medicine is injected to numb the body area where the surgery or procedure will be done. You will remain awake during the surgery or procedure.
  
  
• During Surgery:
  
  
  • Caregivers put your legs up in stirrups (leg holders). A caregiver will clean between your legs and inside your vagina with soap and water. This soap may make your skin yellow, but it can be cleaned off later. Sheets are put over you to keep the surgery area clean. Instruments called dilators are used to open the cervix enough to put in the hysteroscope. Carbon dioxide gas or a solution, such as glucose (sugar) water, may be put inside the uterus. This distends (stretches open) the inside of the uterus so caregivers can see inside the uterus.
    
    
  • A hysteroscope is a long metal tube with a light and mirror on one end. A camera may be attached to the other end of a hysteroscope. Caregivers will watch the surgery on a TV screen. If you are awake, you may also watch the surgery. Your doctor puts the hysteroscope into the uterus to look inside. The tissue on the inside of the uterus and the openings into the fallopian tubes can be checked. Special instruments can be used to check or remove polyps, cancer, an IUD, or check for other problems. If you are awake during surgery, you may feel some cramping.
  
  
• After Surgery: You will be taken to a recovery room. You will be watched closely in this room until caregivers know that you are OK. You will then be taken back to your room. You may be able to go home right after surgery, or you may need to stay in the hospital. A sanitary pad will be placed between your legs. A caregiver may check the pad soon after surgery to watch for bleeding. Do not get out of bed until your caregiver says it is OK. If gas was used in your uterus, or if you also had a laparoscopy, you may have shoulder pain. This pain usually goes away in a short time.
  
  
• Deep breathing and coughing: This will help decrease your risk for a lung infection after surgery.
  
  
  • Hold a pillow tightly against your incision when you cough to help decrease pain. Take a deep breath and hold it for as long as you can. Deep breaths help open your airways. Let the air out and follow with a strong cough. Spit out any mucus you cough up. Repeat the steps 10 times every hour.
    
    
  • You may be given an incentive spirometer to help you take deep breaths. Put the plastic piece into your mouth and take a slow, deep breath. Let out your breath and cough. Repeat the steps 10 times every hour.
  
  
• Food and drink after surgery: You will be able to drink liquids and eat certain foods once your stomach function returns after surgery. You may be given ice chips at first. Then you will get liquids such as water, broth, juice, and clear soft drinks. If your stomach does not become upset, you may then be given soft foods, such as ice cream and applesauce. Once you can eat soft foods easily, you may slowly begin to eat solid foods.
  
  
• Medicines:
  
  
  • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
    
    
  • Antinausea medicine: This medicine may be given to calm your stomach and to help prevent vomiting.
    
    
  • Pain medicine: Caregivers may give you medicine to take away or decrease your pain.
    
    
    • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.
      
      
    • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.
    Stool softeners: This medicine makes it easier for you to have a bowel movement. You may need this medicine to treat or prevent constipation.
  
  
• Oxygen: You may need extra oxygen if your blood oxygen level is lower than it should be. You may get oxygen through a mask placed over your nose and mouth or through small tubes placed in your nostrils. Ask your caregiver before you take off the mask or oxygen tubing.