What is a hysteroscopy?

A hysteroscopy is a procedure to look at the inside of your uterus (womb) using a small telescopic camera (hysteroscope). The hysteroscope is passed through your vagina, across your cervix and into your womb. The womb is then inflated using fluid in order to obtain a clear view.

Hysteroscopy allows your gynaecologist to see clearly inside the uterus but does not produce any images of structures outside the uterus, such as ovaries or other pelvic organs. To evaluate those structures, your gynaecologist may arrange a pelvic ultrasound or laparoscopy, to be done at the same time as the hysteroscopy or separately.

What is diagnostic hysteroscopy?

When hysteroscopy is performed to make a diagnosis, it is known as diagnostic hysteroscopy.  It is considered the gold-standard investigation for heavy bleeding (menorrhagia), irregular bleeding and abnormal bleeding after menopause (post-menopausal bleeding). It is also used to evaluate any suspected uterine abnormalities that cause fertility issues or difficulty in falling pregnant.

During the hysteroscopy, your gynaecologist may take a biopsy from the lining of the uterus. Biopsies taken in this manner are highly accurate in ruling out cancers inside the uterus or confirming the presence of polyps or fibroids.

A diagnostic hysteroscopy usually takes less than 30 minutes to complete and is done as a day case procedure. You should be able to return to normal activities the next day. You may get some cramps and mild bleeding.

Many women undergo diagnostic hysteroscopy in the outpatient clinic, whereas others prefer the procedure to be done under general anaesthesia in the operating theatre. This choice is dependent on many factors including patient preference, previous normal deliveries or cervical surgery, and if any operative procedures need to be done at the same time.

What are the alternatives to hysteroscopy?

Your gynaecologist may recommend a pelvic ultrasound scan or a ultrasound scan through your vagina (known as a transvaginal scan) or perform a biopsy using a small tube placed across your cervix (neck of your womb).

What are the complications of hysteroscopy?

Hysteroscopy is a relatively safe procedure. However, as with any type of surgery, complications are possible. With hysteroscopy, complications occur in less than 1% of cases and can include:

  • Pain
  • Bleeding
  • Infection
  • Injury to the cervix, uterus, bowel or bladder
  • Intrauterine scarring
  • Risks associated with anaesthesia

What to expect after a hysteroscopy?

After your hysteroscopy, you will have some bleeding from the vagina like a menstrual period. It is common to experience some dull pain over the lower abdomen, similar to a menstrual cramp. The pain will usually resolve after some rest in the evening following the procedure. Most women can resume normal activities in 1-2 days.

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