Perforated Uterus?

I just had a hysteroscopy, and the doctor called to say that he had to disclose that he had perforated the uterine wall. Do you have any suggestions on antibiotics? Can you tell me what the effects of this could be?

– May 31, 2011

Hysteroscopy is a method of examining the inside of the uterus with a thin, telescope-like device (called a hysteroscope) inserted via the vagina. It is used to visualize the uterine wall for causes of infertility, recurrent miscarriage or, most often, to investigate the cause of abnormal uterine bleeding. The most frequent complication of the procedure is perforation of the uterus. Usually, perforations close up on their own, but in some cases they can cause bleeding or damage to other internal organs. If so, surgery may be required.

I discussed your question with Arianna Sholes-Douglas, M.D., FACOG, an obstetrician/gynecologist and fellow at the Arizona Center for Integrative Medicine. Dr. Sholes-Douglas told me that the fact that you’re apparently at home and submitting a question to my website is good news, suggesting that you’re doing well and that the perforation probably will not result in any health problems. If a uterine perforation is going to cause symptoms, they usually occur in the first 48 to 72 hours after the procedure. If an infection were to develop, you probably would notice tenderness when you press on your uterus, along with fever, chills and a foul-smelling vaginal discharge, but Dr. Sholes-Douglas emphasized that if nothing happens during the first two or three days after the hysteroscopy, you’re unlikely to have a problem.

You need not worry about long-term effects either. A uterine perforation presents no risk of uterine rupture during pregnancy or any other threat to your health. “Typically, a perforation heals up and you never know it was there,” added Dr. Sholes-Douglas.

Andrew Weil, M.D.

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