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Hysteroscopy: information for patients

Background

A hysteroscopy is an examination of the inside of your womb (uterus) using a narrow, tube-like telescope called a hysteroscope. This instrument is very slim (about 3 to 5mm in diameter). It’s carefully passed through the vagina and cervix, and into the womb.

A hysteroscopy is useful for finding out what is causing symptoms or as a check-up for certain gynaecological conditions, and can also be used to deliver treatment.

During the hysteroscopy procedure your we may take a biopsy (a small sample of tissue) for examination in a laboratory. It’s also possible to remove polyps (small lumps of tissue that may be found on the womb lining).

A hysteroscopy is routinely done as an out-patient or day-case procedure, with no overnight stay.

Hysteroscopy procedures can be performed with or without local anaesthesia, especially if no treatment is planned (a diagnostic hysteroscopy). Often it’s done under general anaesthesia (an operative hysteroscopy), particularly if we are suspicious of finding some abnormality. This means you will be asleep during the procedure.

We will explain the benefits and risks of having a hysteroscopy, and will also discuss the alternatives to the procedure.

About the procedure

We will use a speculum to gently access the cervix (like having a smear test). The vagina and cervix are cleaned with an antiseptic solution. Then we pass the hysteroscope through the cervix and into the womb. Fluid is usually pumped into the womb to make it expand and the womb lining easier to see.

A camera lens at the end of the hysteroscope sends pictures from the inside of the womb to a video screen. We will look at these images and may take a biopsy for examination. Afterwards, the hysteroscope is gently removed. The test usually takes about 10 to 20 minutes.

Following the procedure, you may have slight period-like cramps, as well as “referred pain” in the tip of your shoulders – caused by the fluid used to inflate the womb. This usually disappears within 48 hours.  You may also have some vaginal bleeding for a few days

Hysteroscopy is a commonly performed and generally safe procedure. For most women, the benefits in terms of having a clear diagnosis, or quick and effective treatment, are much greater than any disadvantages. However, all medical procedures carry an element of risk.

Specific complications of hysteroscopy are very uncommon but it’s possible to develop pelvic infection afterwards, requiring treatment with antibiotics. Very rarely, the womb can be perforated or damaged during the hysteroscopy. This can lead to bleeding and infection, and may require further surgery. The chance of complications depends on the exact type of procedure you are having and other factors such as your general health.