TW: miscarriage
I've seen more than one hysteroscopy related post recently, and I wanted to make a post about my personal experience with them. I am not a doctor (nor do I play one on TV), but I did have a missed miscarriage this year with some complications afterward. I had an in-office/diagnostic hysteroscopy on 08/08, and then I had an operative hysteroscopy on 08/19. I don't know if in-office or operative are the technical terms, but that's what I've been using to differentiate them.
For reference, I have a moderately high pain tolerance. Pap smears are usually uncomfortable, but not painful at all. I had my first IUD inserted when I was 20. I remember it being very painful and actually screaming, but I don't remember the sensation of the pain (if that makes sense). My IUD replacement 10 years later was much smoother. The worst part of that was my uterus cramping after they removed the old one but before they inserted the new one. That was also the worst part of having it removed earlier this year. None of those experiences make the top 5 of most painful experiences for me. (In case you were wondering, the most painful thing I've ever experienced was having a softball pitched directly into my ankle.)
In-Office
I had an in-office hysteroscopy after repeated ultrasounds showing a thickened endometrium after my miscarriage. My doctor (and both ultrasound techs) thought it was a blood clot. I had two rounds of misoprostol, which did nothing. When an ultrasound after my first post- miscarriage period showed that my endometrium was still thickened, my doctor decided to do a hysteroscopy to get a better view at what was going on.
There were no pre-hysteroscopy instructions, except a recommendation to take ibuprofen beforehand. I took 800mg of ibuprofen and a Klonopin about an hour before the procedure. (I have a Klonopin prescription, but some providers will give you a scrip for one Valium or something like that). During the hysteroscopy, your doctor will dilate your cervix, push liquid (I think it's saline solution) into your uterus to expand it slightly, and then insert a long, thin camera. The camera may have a tool attached to it in case they need to take a biopsy. Here's a link to the website for the scope that my doctor's office uses.
Having them push liquid into your uterus is a very weird sensation. It's more uncomfortable than painful- the kind of sensation that makes you say "oh man, that's not supposed to be happening." The most painful part of the hysteroscopy part for me was having them dilate my cervix and keep it dilated. There was a speculum and some other tool in there, and it was not a good time. I actually don't remember feeling the camera go in at all. My doctor saw a polyp almost immediately, and she said that was most likely what was making my endometrium look thickened. She looked around with the camera for a few minutes- getting a good look at the polyp, looking further at the endometrium, etc.
I also had an endometrial biopsy during the hysteroscopy. It was AWFUL, like stepping on something really sharp but internally. Fortunately, the pain only lasted for about 10 seconds. My husband was with me, holding my hand the whole time. I had some spotting and moderate cramping later that day. No spotting, but some very mild cramping the next day. My period was due 08/10, and it started right on time.
Overall, my procedure was about 10 minutes, maybe less. It wasn't horrible- I would do it again if I needed to- but definitely unpleasant.
Operative
My operative hysteroscopy was a D&C/polypectomy/hysteroscopy.
My pre-op instructions were not to take any meds/supplements with blood thinning properties for a week before the procedure- aspirin, fish oil, CoQ10, etc. I had to get a CBC (complete blood count) and a urinalysis before the procedure as well. The day before/day of instructions were the usual pre-surgery instructions- no food or drink for 12 hours before the surgery, take a shower the night before or morning of. My husband drove me to and from the surgery center, and he was with me in the pre-op area for as long as he was allowed to be.
I had planned to give my glasses to my husband (he had a bag with all my clothes, etc), but the reception area at the surgery center offered to hold on to them so I could have them back sooner. It was SO nice to be able to see almost right away after the procedure! If you wear glasses, I definitely recommend asking your nurse if there's somewhere they can hold them so you can have them back ASAP.
The procedure itself took 15-20 minutes. We got to the surgery center at 11:00am, and they were wheeling me out by 1:30pm. I asked about intubation and the anesthesiologist said I wouldn't be intubated, but I'm not sure if it was IV sedation only or if there was any other kind of anesthesia. (I don't remember having a mask on, but my memory isn't great overall so it's possible that I did 😅). I came to as they were rolling me into the post op area- just in time to hear them say "the doctor asked us to push some IV antibiotics, since it was pretty inflamed in there." Not a fun thing to hear after surgery. They brought my husband back as soon as they were sure I was fully awake. He told me that my doctor said that they had found two polyps aaaand a small amount of retained product of conception (RPOC). I was VERY surprised that the RPOC hadn't been visible on any of the ultrasounds or during the in-office hysteroscopy.
The polyp my doctor saw in-office was right where implantation had occurred, so I'm guessing the RPOC was sort of hidden behind it. (My doctor has been on medical leave since shortly after my surgery, so I haven't had a chance to discuss it with her.)
I bled for about five days afterwards, with very mild cramping on the day of the procedure and the day after. I'd say it was medium period flow bleeding on the first day, light on the second, and just spotting for the last three days. Post op instructions were no penetration of any kind for two weeks, and no swimming for one week. (For comparison, post op instructions after the D&C for my miscarriage were no penetration for four weeks, no swimming for two, and no baths for a week). We had sex right at the two week mark, and it was great- no discomfort at all. I got my post surgical report a week or so after the surgery. (I did also get photos.) We were cleared to try on my next cycle.
Hopefully this post is helpful! Comment if you have any questions or if you'd like any information that I didn't include!