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Hysteroscopy

hysterscopy

A hysteroscopy is a procedure that allows a surgeon to look inside your womb (uterus) using a narrow tube-like telescopic camera called a hysteroscope.

A hysteroscopy can be used either to diagnose or treat a gynaecological condition.

You will meet the consultant who will perform your procedure to discuss your care during an initial consultation. It may differ from what is described in this document because it will be designed to meet your individual needs.

You may be advised to have a hysteroscopy in order to:

  • help find out what is causing your symptoms, for example if you have heavy periods
  • check for conditions such as polyps (small growths of tissue in your womb lining) or some types of fibroids (non-cancerous growths of muscle in your womb
  • see if there are any problems within your womb if you’re having problems getting pregnant or have had several miscarriages
  • treat scar tissue (adhesions) within the lining of your womb
  • put in an intra-uterine system (IUS), or coil, or take out a coil that has moved out of place

The procedure

A hysteroscopy typically takes about 30 minutes. Your surgeon will put a medical instrument called a speculum into your vagina to see into your cervix (neck of your womb). They will then clean your vagina and cervix with an antiseptic solution and pass a hysteroscope into your womb. The camera on the end of the hysteroscope sends pictures from the inside of your womb to a video screen. Your surgeon will look at these images and, if necessary, take a biopsy or perform any treatment, such as removal of a polyp. He or she may inject some gas or fluid, which can make it easier to see your womb lining.

Preparation

Your consultant will explain how to prepare for your procedure. For example, if you smoke you will be asked to stop, as smoking increases your risk of getting a chest infection and slows your recovery.

Hysteroscopy used is usually performed as a day-case procedure under intravenous sedation, which means you will not feel anything during the procedure. If you’re having sedation, you will be asked to follow fasting instructions. This means not eating or drinking, typically for about 12 hours beforehand. However, it’s important to follow your consultant’s or their assistant’s advice.

Your consultant will discuss with you what will happen before, during and after your procedure, and any pain you might have. This is your opportunity to understand what will happen, and you can help yourself by preparing questions to ask about the risks, benefits and any alternatives to the procedure. This will help you to be informed, so you can give your consent for the procedure to go ahead, which you will be asked to do by signing a consent form.

After the procedure

You will need to rest until the effects of the sedation you received have passed. Once you feel ready, you will need to arrange for someone to drive you home and you should try to have a friend or relative stay with you for the first 24 hours.

Intravenous sedation can temporarily affect your coordination and reasoning skills, so you should not drive, drink alcohol, operate machinery or sign legal documents for 24 hours afterwards. If you’re in any doubt about driving, contact your motor insurer so that you’re aware of their recommendations, and always follow your surgeon’s advice.

You may need to wear a sanitary towel as the procedure can cause you to have some vaginal bleeding. If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.

Your nurse may give you a date for a follow-up appointment. If you have a biopsy or polyps removed, the results will be sent in a report to your doctor.

If you have a diagnostic hysteroscopy, you will need to rest and take it easy for a day or two. If you have had treatment during the hysteroscopy, for example if you have had a polyp or fibroid removed, your recovery may take longer. Your consultant will advise you when you can get back to your usual activities.

Risks

As with every procedure, there are some risks associated with hysteroscopy. We have not included the chance of these happening as they are specific to you and differ for every person. Ask your consultant to explain how these risks apply to you.

Side effects

Side effects are the unwanted but mostly temporary effects you may get after having the procedure. For example, you may have cramping pains, like those you get during a period. You may also have some vaginal bleeding, which usually gets better after a few days, but can last for up to a week.

Complications

This is when problems occur during or after the procedure. Most women aren’t affected. The possible complications of any operation include an unexpected reaction to the anaesthetic, excessive bleeding or developing a blood clot, usually in a vein in your leg (deep vein thrombosis, DVT).

Specific complications of hysteroscopy are uncommon, although it’s possible you may develop an infection afterwards, which can lead to infertility – but this is rare. The surgery may damage your womb and, rarely, your bladder, bowel and blood vessels. If this happens, you may need further surgery to repair any damage caused.

During the procedure, it may not be possible for your surgeon to pass the hysteroscope into your womb to get a clear view of the lining. If this happens, they will discuss alternative options with you. You may need to have a laparoscopy (keyhole surgery) or laparotomy (open surgery) instead.

Most women don’t have any problems after having a hysteroscopy. However, if you develop any of the following symptoms, contact the clinic.

  • Long-lasting, heavy bleeding.
  • Vaginal discharge that is dark or smells unpleasant.
  • Severe pain or pain that lasts for more than 48 hours.
  • A high temperature.

Speak to your consultant for more information about complications of hysteroscopy.

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