Hysteroscopy is the process of using a viewing scope to examine the interior of the uterus along with the cervical canal. The scope is inserted through the vagina and into the cervical opening. The procedure can be performed as an aid in the diagnosis of problems with the uterus, or it may be combined with simple surgical techniques for treatment purposes.
Why it is used
A hysteroscopy can be used to diagnose cases when a woman’s symptoms suggest there could be a problem with their womb. Symptoms can include:
heavy periods or irregular periods
bleeding between normal periods, after sexual intercourse or after menopause
unusual vaginal discharge
A hysteroscopy can also be used to remove abnormal growths from the womb, such as:
fibroids – non-cancerous growths that can develop inside the womb and can sometimes cause symptoms such as pain and heavy periods
polyps – small growths that develop on the lining of the womb and can cause irregular and heavy periods
intrauterine adhesions – sections of scar tissue that can cause absent periods and infertility
thickening of the uterus' lining (endometrial hyperplasia) – this can increase the risk of womb cancer
A procedure called dilatation and curettage (D&C) used to be commonly used to examine the womb and remove abnormal growths, but nowadays hysteroscopies are carried out instead.
What happens during a hysteroscopy?
A hysteroscopy is a common procedure that is often carried out on an outpatient basis. This means you do not have to stay overnight.
It is performed under sedation. The surgeon will use a device called a speculum to open up the walls of the vagina, in the same way it is used during a cervical smear test. The surgeon will then insert the hysteroscope through the cervix, into the womb.
Gas or fluid is often used to inflate the womb, to give the surgeon a better view.
If a biopsy or treatment is needed, such as the removal of polyps, other instruments will be passed into the womb.
A hysteroscopy usually takes between 10 and 30 minutes, depending on what needs to be done.
Recovering from a hysteroscopy
Some women will experience cramping similar to period pains after a hysteroscopy, but this usually passes after a few days.
Most women feel they can return to normal activities, such as work, the day after the procedure.
A hysteroscopy is a very safe procedure, with a low risk of complications.
The two most commonly reported complications of a hysteroscopy are:
accidental damage to the womb or cervix, which may require further treatment to correct – this occurs in around 1 in 135 cases
excessive bleeding during or after surgery, which happens in around 1 in 400 cases
In almost all cases, the benefits of having a hysteroscopy far outweigh the potential risks.