What is a hysteroscopy?

A hysteroscopy is a procedure used to examine the inside of your uterus (womb). It involves using a hysteroscope, a thin, telescope-like instrument with a light and camera at the end. The hysteroscope is inserted into your uterus through the vagina and cervix, meaning no incisions are made in your skin. This allows your gynaecologist to view the inside of your uterus on a monitor. Hysteroscopy can be used for both diagnostic and operative purposes, enabling the diagnosis and treatment of conditions such as abnormal bleeding, fibroids, and polyps.

Why is a hysteroscopy performed?

Your gynaecologist may recommend a hysteroscopy for several reasons:

To investigate symptoms or problems:

• Abnormal bleeding: To investigate the cause of heavy or irregular menstrual bleeding or bleeding after menopause.
• Pelvic pain: To identify any underlying issues causing pelvic pain.
• Miscarriages: To investigate recurrent miscarriages.
• Infertility: To assess the shape and structure of your uterus in cases of unexplained infertility.

To diagnose conditions:

• Fibroids and polyps: To detect and possibly remove fibroids or polyps (non-cancerous growths) within your uterus.
• Endometrial biopsy: To obtain a tissue sample from the lining of your uterus for further examination.

To treat conditions and problems:

• Intrauterine device (IUD) problems: To locate and remove a misplaced IUD.
• Fibroids and polyps: Removal of fibroids or polyps.
• Intrauterine adhesions: Removal of adhesions (scar tissue that causes absent periods and reduced fertility).

In the past, a procedure called dilatation and curettage (D&C) was commonly used to examine the womb and remove abnormal growths. Hysteroscopy has largely replaced this procedure.

How is a hysteroscopy performed?

Hysteroscopy is typically performed as an outpatient procedure, so you can go home the same day. The procedure can be done under local anaesthetic, sedation, or general anaesthetic, depending on the complexity and your preference.

• Preparation: You will lie on a couch with your legs in supports, and a sheet will be used to cover your lower half. A speculum (the same instrument used for a cervical screening test) may be inserted into your vagina to hold it open.
• Insertion: The hysteroscope is gently inserted through your cervix into your uterus. Saline solution may be used to expand your uterus, allowing the gynaecologist a clear view of the uterine cavity.
• Examination and treatment: The gynaecologist examines your uterine lining on a monitor. If necessary, small instruments can be passed through the hysteroscope to perform procedures such as removing polyps or taking a biopsy. You may feel pain or discomfort, so it’s recommended that you take pain relief (such as paracetamol or ibuprofen) 1 to 2 hours before the appointment. If it becomes too painful, let your gynaecologist know, as the procedure can be stopped at any time.
• Completion: The hysteroscope is removed, and the procedure is complete. The entire process typically takes between 5 to 30 minutes, depending on whether any treatment is carried out.

Recovery and aftercare

After a hysteroscopy, you may experience mild discomfort and can usually return to normal activities within a day or two. It’s common to feel some cramping, similar to menstrual pain, and to have light bleeding for a few days. Over-the-counter pain relief, such as paracetamol or ibuprofen, can help manage any discomfort.

If you had a general anaesthetic, you might feel drowsy or tired for the rest of the day, so it’s important to have someone accompany you home. Avoid driving, operating machinery, or making important decisions for 24 hours after the anaesthetic. You should avoid having sex for a week, or until any bleeding has stopped, to reduce the risk of infection.

Your gynaecologist will discuss the findings of the procedure with you before you leave the hospital. Follow-up appointments may be scheduled to discuss the results of the hysteroscopy and any further treatment if necessary.

Risks and complications

Hysteroscopy is generally a safe procedure, but like all medical procedures, it carries some risks. These may include:

• Cramping or pain: Some discomfort is common during and after the procedure, similar to period pain.
• Bleeding: Light bleeding or spotting can occur for a few days after the procedure.
• Infection: Though rare, there is a small risk of infection. Symptoms may include fever, severe pain, or unusual discharge.
• Uterine perforation: Very rarely, the hysteroscope may puncture the uterus, which may require further treatment.

Your gynaecologist will discuss these risks with you before the procedure and advise on how to manage any potential complications.

When to seek medical advice

While complications are rare, it’s important to know when to seek medical advice. Contact your gynaecologist or visit your nearest A&E if you experience:

• Severe pain that isn’t relieved by painkillers.
• Heavy bleeding or passing large blood clots.
• Signs of infection, such as fever, chills, or foul-smelling discharge.
• Persistent nausea or vomiting.

Why choose Birmingham Gynaecology Clinic?

Choosing Birmingham Gynaecology Clinic means entrusting your care to a team of experienced specialists dedicated to providing the highest standard of treatment. Our gynaecologists are skilled in performing hysteroscopies with the latest technology, ensuring accurate diagnoses and effective treatments. We prioritise your comfort and well-being, offering personalised care tailored to your individual needs.

Contact us

For more information or to schedule a hysteroscopy, please contact Birmingham Gynaecology Clinic. Our team is here to support you at every step of your healthcare journey. Reach out today to take control of your gynaecological health.