Hysteroscopy

A hysteroscopy is a procedure to examine the inside of your uterus (womb) using a thin, flexible tube with a light and camera (called a hysteroscope). It is minimally invasive procedure and often done as an outpatient office hysteroscopy to:

• Diagnose conditions (e.g., abnormal bleeding, polyps, fibroids).
• Treat problems (e.g., remove growths, take biopsies, or remove misplaced contraceptive devices).
• Investigate infertility or recurrent miscarriages.

Why might I need a Hysteroscopy?

Your gynaecologist may recommend a hysteroscopy if you have:

• Heavy, irregular, or postmenopausal bleeding.
• Suspected polyps, fibroids, or adhesions (scar tissue).
• Unexplained pelvic pain or infertility.
• Abnormal results from a cervical screening or ultrasound.

Before the Procedure

• Scheduling: The test is usually done when you’re not menstruating (ideally days 5–12 of your cycle).
• Pregnancy test: Required if there’s any chance you could be pregnant.
• Pain relief: You may be offered painkillers (e.g., ibuprofen) to take beforehand.
• Anaesthesia:
  • Local anaesthetic (numbing the cervix) is common.
  • General anaesthetic may be used for longer or more complex procedures.
• Preparation:
  • Avoid sex, tampons, or vaginal creams for 24 hours before.
  • Arrange transport home if having sedation/general anaesthetic.

During the Procedure

• Positioning: You’ll lie on a couch with your legs supported (similar to a smear test).
• Inserting the sterile hysteroscope or single use hysteroscope:
  The cervix is gently dilated (widened) if needed.
  The hysteroscope is passed through the vagina and cervix into the uterus.
  Normal saline is used to expand the uterus for better visibility.
• Examination/treatment:
  The camera sends images to a screen.
  Biopsies or minor treatments (e.g., removing polyps) may be performed.
• Duration: 10–30 minutes (longer if treatment is needed).

After the Procedure

• Recovery: Most women go home the same day.
• Common side effects:
  • Mild cramping or spotting for 1–2 days.
  • Temporary dizziness (if sedation was given).
• Self-care:
  • Rest for 24 hours. Avoid sex, tampons, or swimming for 48 hours (to reduce infection risk).
  • Use sanitary pads (not tampons) for any bleeding.
  • Pain relief: Paracetamol or ibuprofen can help with cramping.

Risks and Complications

• Common (temporary):
  • Light bleeding, cramping, or vaginal discharge.
• Rare but serious:
  • Infection (symptoms: fever, foul-smelling discharge). Uterine perforation (a small hole in the womb – may require further treatment).
  • Heavy bleeding (soaking a pad hourly).

Follow-Up

• Results: Discussed at a follow-up appointment (usually 2–6 weeks later).
• Further treatment: Depends on findings (e.g., medication, surgery).