A hysteroscopy is a procedure where a camera is inserted through the opening in your cervix into the uterine cavity and allows us to look inside the uterus. This is currently normally done in the operating room with either sedation and freezing injected into the cervix, or a general anesthetic.
The first step is to dilate open the cervix so the camera can be inserted. During the dilation there is a risk of perforation of the uterus, which means that the dilator can make a hole through the wall of the uterus instead of going into the uterine cavity. This is fairly uncommon, but is more likely if your cervix is very tightly closed.
Once the cervix is dilated open, the camera can be inserted and the inside of the uterus can be seen. We look for any abnormalities such as masses or polyps. If present these can often be removed during the procedure. Most often even if the uterus appears normal, we take a small sample of the lining (called a curettage) while we are there to ensure that there are no microscopic abnormalities of the lining. This combination of hysteroscopy with dilation and curettage is often done to assess abnormal or heavy bleeding, or post menopausal bleeding.