Hysteroscopy: Direct Visualization of the Uterine Cavity
Hysteroscopy uses a thin lighted camera — the hysteroscope — inserted through the cervix into the uterine cavity, providing direct visualization of the endometrium, the uterine walls, and the tubal openings. It is the most accurate way to evaluate the uterine cavity for polyps, fibroids, adhesions, and structural abnormalities — and it can be performed in the office without general anesthesia.
Diagnostic hysteroscopy examines the cavity and identifies what is present. Operative hysteroscopy goes further — removing polyps, small fibroids, or adhesions in the same session. Dr. Andrei performs both diagnostic and selected operative hysteroscopy at the Lapeer and Rochester Hills offices as in-office procedures, eliminating the cost, recovery time, and scheduling complexity of a hospital operating room.
When hysteroscopic findings require a more extensive operative intervention — large submucosal fibroids, complex adhesions, or resection procedures requiring general anesthesia — Dr. Andrei performs those cases at McLaren Lapeer, McLaren Flint, or Henry Ford Rochester Hospital. The in-office evaluation determines which setting is appropriate for treatment.
Indications for In-Office Hysteroscopy
Hysteroscopy is the most accurate evaluation available for uterine cavity pathology. These are the most common reasons Dr. Andrei recommends it.
Abnormal uterine bleeding
Heavy, irregular, or postmenopausal bleeding not explained by ultrasound or biopsy — hysteroscopy provides direct visualization of the bleeding source.
Endometrial or uterine polyps
Polyps identified on ultrasound or suspected from irregular bleeding — hysteroscopy confirms the diagnosis and allows removal in the same session when size permits.
Submucosal fibroids
Fibroids protruding into the uterine cavity causing heavy periods or difficulty with implantation — hysteroscopy evaluates extent and guides treatment planning.
Unexplained infertility or implantation failure
Uterine cavity evaluation prior to IVF or after repeated IVF failures — identifying polyps, fibroids, or adhesions that may be interfering with implantation.
Uterine adhesions (Asherman’s syndrome)
Scar tissue within the uterine cavity causing absent or reduced periods and fertility difficulties — hysteroscopy diagnoses and treats adhesions.
Abnormal findings on prior imaging
Uterine abnormality on ultrasound or sonohysterogram requiring direct visualization — hysteroscopy provides definitive evaluation when imaging is inconclusive.
The Hysteroscopy Procedure — Step by Step
In-office hysteroscopy at Lapeer Women’s Health takes approximately 20 minutes. No hospital, no general anesthesia, no recovery room. Most patients return to normal activity the same day.
Preparation
You are positioned as for a pelvic exam. A speculum is placed. The cervix is cleaned with antiseptic solution. Local anesthetic is applied to the cervix to minimize discomfort. Ibuprofen taken one hour before the appointment significantly reduces cramping.
Hysteroscope Insertion
The hysteroscope — a thin camera approximately 3–4mm in diameter — is gently passed through the cervical opening into the uterine cavity. Saline distends the cavity to allow clear visualization.
Cavity Survey
Dr. Andrei systematically surveys the entire uterine cavity — examining the anterior and posterior walls, the lateral walls, the tubal openings, and the endometrial surface. Any polyps, fibroids, adhesions, or abnormalities are identified and documented.
Treatment (if operative)
When diagnostic findings warrant immediate treatment — such as a polyp appropriate for in-office removal — Dr. Andrei proceeds with operative hysteroscopy at the same session. Tissue removed is sent to pathology.
Recovery and Results
The hysteroscope is removed and you rest briefly before leaving. Mild cramping and light spotting are expected for one to two days. Dr. Andrei discusses findings immediately after the procedure and reviews pathology at your follow-up appointment.
Common Questions About Hysteroscopy
A Direct Answer.
No Operating Room Required.
If ultrasound has shown an abnormality, bleeding has not been explained, or infertility evaluation is underway — hysteroscopy provides direct visualization of the uterine cavity without a hospital visit, general anesthesia, or significant recovery time.
The information on this page is intended for educational purposes only and does not constitute medical advice. Individual symptoms, diagnoses, and treatment options vary significantly. Reading this content does not establish a physician-patient relationship with Dr. Ramona D. Andrei or Lapeer Women’s Health. If you are experiencing a medical emergency, call 911 or go to the nearest emergency room immediately. Please consult a qualified healthcare provider for advice specific to your situation. Content reviewed by Dr. Ramona D. Andrei, MD PhD FACOG.
Gynecologic care for women of every age
Lapeer Women’s Health — Rochester Hills
2710 S Rochester Rd, Suite 2
Rochester Hills, MI 48307
Serving patients in Lapeer, Rochester Hills, and surrounding communities throughout Southeast Michigan.