Hysteroscopy is a procedure in which the inside of the uterus is viewed directly with a thin camera (hysteroscope). The hysteroscope is passed through the cervix into the uterus. To give a clear view, the uterine cavity is gently expanded with saline, and the images are shown on a screen. No incision is made in the abdomen.
When is it performed?
- Unexplained, irregular or heavy menstrual bleeding
- Bleeding between periods or after menopause
- Investigation of difficulty getting pregnant (infertility)
- Recurrent pregnancy loss
- Suspected polyps, fibroids, adhesions or shape abnormalities inside the uterus on ultrasound
Diagnostic and operative hysteroscopy
- Diagnostic hysteroscopy: performed to examine the inside of the uterus.
- Operative hysteroscopy: during the procedure it is possible to remove polyps or fibroids inside the uterus, release intrauterine adhesions, correct a uterine septum, take a tissue sample (biopsy) or remove an intrauterine device that cannot be located.
How is it performed?
Depending on the scope of the procedure, it can be done under local anaesthesia or under sedation / general anaesthesia. Diagnostic hysteroscopy usually takes 10–15 minutes; operative procedures may take longer. Most patients can go home on the same day.
After the procedure
- Mild, period-like cramping may occur for a few days and usually settles with simple painkillers.
- Light bleeding or spotting may occur for about a week; using pads rather than tampons is recommended during this time.
- It is advisable to avoid sexual intercourse and strenuous exercise until the pain and bleeding have stopped.
Risks
Hysteroscopy is generally a safe and short procedure. Rarely, complications such as infection, bleeding or perforation of the uterine wall may occur.
When should you contact your doctor?
Contact your doctor if bleeding increases or does not decrease within a few days, if you have abdominal pain that does not improve with painkillers, or if you develop fever or foul-smelling discharge.
This article is for general information. The diagnosis and treatment that are right for you are determined after examination and assessment.