Office hysteroscopy or out-patent hysteroscopy is a minimally invasive procedure that allows your gynaecologist to examine the inside of your uterus (womb) using a thin, lighted telescope (hysteroscope). It is performed in a clinic setting, without general anaesthesia, to diagnose or treat uterine conditions.
Your gynaecologist may suggest this procedure if you have:
- Abnormal uterine bleeding (heavy periods, postmenopausal bleeding)
- Repeated miscarriages or infertility
- Suspected polyps, fibroids, or adhesions (scar tissue)
- Abnormal ultrasound/MRI results
- Removal of a displaced intrauterine device (IUD)
This procedure is not suitable if:
- You are pregnant or suspect pregnancy
- You have an active pelvic infection
- You have cervical or uterine cancer (confirmed or suspected)
Benefits
- Quick & convenient: Done in 10–20 minutes; no hospital stay.
- Accurate diagnosis: Directly visualizes the uterine lining.
- Minimal downtime: Resume normal activities the same/next day.
- Therapeutic options: Can remove small polyps/lesions, displaced coils or take biopsies.
Risks and Complications
- Common (temporary):
- Mild cramping (like period pain)
- Light spotting/bleeding for 1–3 days
- Uncommon (<5%):
- Infection (antibiotics may be prescribed)
- Vasovagal reaction (dizziness/nausea)
- Rare (<1%):
- Uterine perforation
- Fluid overload (if fluid is used to expand the uterus)
Before the Procedure
- Timing: Schedule 1 week after your period (when bleeding is lightest).
- Medications:
- Take pain relief (e.g., ibuprofen/paracetamol) 1 hour before.
- Stop blood thinners (aspirin/warfarin) 3–7 days prior to procedure
- What to wear: Loose, comfortable clothing.
- Avoid: Vaginal creams, douches, or intercourse for 24 hours before.
During the Procedure
- Position: Lie on an examination chair with legs in supports (like a cervical smear).
- Anaesthesia:
Local anaesthetic gel/numbing spray applied to the cervix.
Optional: Oral painkillers or mild sedation (discuss beforehand). - Procedure steps:
A speculum is inserted into the vagina.
The hysteroscope (2–5mm wide) is gently passed through the cervix into the uterus. Saline fluid expands the uterus for clearer viewing (may cause cramping).
Biopsies or minor treatments performed if needed. - After: Rest in clinic for 15–30 minutes; then go home.
Recovery
- Immediately after:
- Cramping (use a heat pad/painkillers).
- Light bleeding (use sanitary pads; avoid tampons).
- At home:
- Rest: Take it easy for 24 hours.
- Avoid: Sex, swimming, baths, and heavy lifting for 48 hours.
- Hydration: Drink plenty of water.
- Return to work: Most resume work the next day.
Results
- Preliminary findings: Discussed immediately after the procedure.
- Biopsy results: Ready in 1–2 weeks (follow-up appointment needed).
eGynaecologist Advice
- Out-patient hysteroscopy is safe and effective way to diagnose and treat some uterine issues. You may feel cramping similar to period pain and pressure or mild discomfort.
- You should seek consultation with your gynaecologist if you develop heavy bleeding (soaking >2 pads/hour), severe abdominal pain or fever or foul-smelling discharge.
- Pregnancy must be avoided for 1–2 months after the procedure (use contraception) to allow endometrium to heal, especially if treatment has been offered during the procedure.
Frequently Asked Questions
Will it hurt?
Most feel mild cramping (like a period). Local numbing gel reduces discomfort.
Can I drive home afterward?
Yes – if no sedation is used. With sedation, arrange a ride.
Does hysteroscopy affect fertility?
No – it may improve fertility by treating issues (e.g., polyps).
What if my bleeding continues beyond 3 days?
Light spotting for up to 1 week is normal. Contact your gynaecologist if bleeding is heavy (soaking 1 pad/hour) or foul-smelling.
Is hysteroscopy the same as a cervical smear?
No – Cervical smears test cervical cells; hysteroscopy examines the uterine cavity.
