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Laparoscopy and Hysteroscopy

An examination of a woman’s internal pelvic structure can provide important information regarding infertility and common gynecologic disorders. Problems that cannot be discovered by an external physical examination may be discovered by laparoscopy and hysteroscopy, two procedures that provide a direct look at the pelvic organs. These procedures may be recommended as part of your infertility care, depending on your particular situation. Laparoscopy and hysteroscopy can be used for both diagnostic (looking only) and operative (looking and treating) purposes.

Diagnostic laparoscopy may be recommended to look at the outside of the uterus, fallopian tubes, ovaries, and internal pelvic area. Diagnostic hysteroscopy is used to look inside the uterine cavity. If an abnormal condition is detected during the diagnostic procedure, operative laparoscopy or operative hysteroscopy can often be performed to correct it at the same time, avoiding the need for a second surgery. Both diagnostic and operative procedures should be performed by physicians with surgical expertise in these areas. The following information will help patients know what to expect before undergoing any of these procedures.

Hysteroscopy is a useful procedure to evaluate women with infertility, recurrent miscarriage, or abnormal uterine bleeding. Diagnostic hysteroscopy is used to examine the uterine cavity (Figure 3), and is helpful in diagnosing abnormal uterine conditions such as fibroids protruding into the uterine cavity, scarring, polyps, and congenital malformations. A hysterosalpingogram (an x-ray using dye to outline the uterus and fallopian tubes), pelvic ultrasound or sonohysterogram (ultrasound with introduction of saline into the uterine cavity), or an endometrial biopsy may be performed to evaluate the uterus prior to hysteroscopy.

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