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What is a hysteroscopy?
A hysteroscopy is an examination of the inside of the womb (uterus) using a thin telescope (a hysteroscope) with a camera and light at the end.
Hysteroscopy uses all the natural openings of the female genital tract; the hysteroscope is passed into the vagina, through the neck of the womb (cervix) and then into the womb. Salt-water (saline) is used to distend the cavity of the womb, allowing the specialist to visualise the lining of the womb (endometrium) and perform any treatment that may be necessary. The procedure usually takes 10-20 minutes.
Why do I need a hysteroscopy?
You may need a hysteroscopy if you have:
- Abnormal periods (heavy or irregular)
- Vaginal bleeding after you have gone through the menopause (post-menopausal bleeding)
- A known endometrial polyp (non-cancerous excess growth of womb lining)
- A known submucosal fibroid (non-cancerous excess growth of womb muscle, extending into the womb cavity)
- A thickened lining of the womb on ultrasound scan
- Difficulties conceiving
- Recurrent miscarriages
- A difficult to remove contraceptive coil
What will happen during a hysteroscopy?
A hysteroscopy can be used to diagnose, investigate and treat gynaecological problems. Depending on the reason why you have been referred, during your hysteroscopy we may:
- Inspect the inside of the womb and lining of the womb only,
- Take a small sample of the lining of the womb (endometrial biopsy),
- Remove a polyp or fibroid
Any specimens that are removed at the time of the hysteroscopy will be sent to the laboratory for examination.
What are the side effects of a hysteroscopy?
Hysteroscopy is a very well tolerated procedure but you may experience the following during or for a short while afterwards:
- Period pain-like cramps
- Vaginal spotting (small spots of blood)
What are the risks of a hysteroscopy?
Hysteroscopy is very safe; however, as with all procedures there are some potential risks:
- Vaginal bleeding
- Infection of the womb or bladder requiring antibiotics
- Creating a small hole in the wall of the womb (uterine perforation). This is a rare occurrence (less than 1 in 1000)
Hysteroscopy can be performed as an outpatient (i.e. with you awake). This is very well tolerated by patients and either requires no anaesthetic or an injection of local anaesthetic into the cervix.
The benefits of having an outpatient hysteroscopy rather than one under general anesthetic are:
- You are able to eat and drink as normal beforehand
- Avoids a general anaesthetic and the associated risks
- Quicker procedure
- Quicker recovery
- Less time spent in hospital
If you are having an outpatient hysteroscopy, we advise you to take paracetamol and/ or ibuprofen one hour before the procedure.
The outpatient hysteroscopy department is located in the Ambulatory Gynaecology Unit, 4th floor, Lanesborough Wing, St George’s Hospital.
Hysteroscopy under general anaesthetic
Sometimes a hysteroscopy needs to be performed under general anaesthetic. Reasons for this can include:
- Unable to pass the hysteroscope through the cervix at outpatient hysteroscopy
- Too much discomfort during outpatient hysteroscopy
- Patient preference
- Polyp or fibroid too large to remove in the outpatient setting
If you are having a hysteroscopy under general anaesthetic, you cannot eat or drink for a certain time period prior to your procedure and you must have someone available to collect you from hospital after your procedure. You will be provided with further details at your pre-assessment appointment.
If you are of child-bearing age, you must use contraception from the start of your period before your hysteroscopy. You cannot have a hysteroscopy if you are or could be pregnant.
Patient information leaflets
You may find the following information leaflets useful:
If you have any questions or concerns about hysteroscopy, please contact the outpatient hysteroscopy secretary on 020 8725 1909 (Monday to Friday, 9am to 5pm).