What is a Hysteroscopy?
A Hysteroscopy is a procedure that lets your doctor look inside your womb (uterus). This is done using a narrow tube-like instrument called a hysteroscope. The hysteroscope is very slim (about 3 to 5 millimetres in diameter). It’s carefully passed through the vagina and neck of the uterus (cervix) and into your uterus. The hysteroscope has a video camera inside which sends pictures to a computer screen. This allows the gynaecologist to check for any abnormalities in the lining of the uterus.
The hysteroscope has special channels which allow the gynaecologist to pass various instruments into the uterus. This means that as well as being able to look inside the uterus, the gynaecologist can perform certain procedures.
What is a Hysteroscopy used for?
A Hysteroscopy may be used to try to determine the cause of various problems such as:
- Heavy or irregular bleeding that has not got better with medication.
- Bleeding in between your periods.
- Bleeding after your menopause
- Irregular bleeding whilst you are taking hormone replacement therapy (HRT).
- If you are thinking about having an operation to make your periods less heavy (eg, endometrial ablation).
- Unexplained miscarriages
What happens during a Hysteroscopy?
A hysteroscopy can either be done under general anaesthetic, which means you will be asleep during the procedure, or with a local anaesthetic. If you have a local anaesthetic you will be awake. You may be given a sedative which won’t put you to sleep but may help you feel more relaxed. If you have a local anaesthetic you may be asked if you wish to see the pictures coming from the hysteroscope. Some people do not wish to do this, but others find it helpful.
Your gy may use a speculum (the same instrument used in a cervical screening test) so that he or she can see the neck of your womb (cervix). Then the doctor passes the hysteroscope through your cerivx into the uterus.
The hysteroscope is connected to a camera and a TV screen, which show the inside of your uterus. Some gas or fluid may be pumped into your uterus to make it expand. This makes it easier to see the lining of your uterus. After this, the doctor may take a tiny piece of tissue from your uterus (biopsy). This will be sent to the laboratory for examination under the microscope. Sometimes polyps are found and it may be possible to remove these during the test. After the procedure is completed the hysteroscope is gently removed.
A hysteroscopy takes between 5-30 minutes. If you are awake you may feel something like period cramps at some stages. A lot of women feel no discomfort, or only minimal discomfort.
What can I expect after a Hysteroscopy?
If you have general anaesthetic, you will need to rest until the effects of the anaesthetic have passed. You will need to arrange for someone to drive you home. You should try to have a friend or relative stay with you for the first 24 hours.
If you have a local anaesthetic, you will usually be able to go home after a short rest. You should feel well enough to walk, travel by bus or train – or to drive home, providing you haven’t been given a sedative.
You may experience some period-like cramps and mild bleeding. The bleeding is usually mild and should settle within seven days. To reduce the risk of infection you should use sanitary towels rather than tampons. Take it easy for the first one or two days and take painkillers as needed.
Possible side effects of a Hysteroscopy?
The most common side-effects of the procedure are bleeding and pain, as mentioned above. Very rarely it is possible that a small hole may be made in the uterus by the hysteroscope. If this happens you would need to stay in hospital overnight. It is also possible, although not common, to develop an infection of the uterus as a result of hysteroscopy.