Hysteroscopy

This is an endoscopic examination ( using a camera) of the vagina and the uterine cavity. This is carried out as an out patient ( in clinic) or Day case ( under general anaesthesia) procedure.

This is usually performed for investigating conditions like abnormal uterine bleeding or recurrent miscarriages. Hysteroscopy is also used to remove endometrial fibroids and polyps that may be the cause of intermenstrual or heavy bleeding.

Out patient hysteroscopy

If you have been offered an out patient hysteroscopy it is always a good idea to take some pain killers 1-2 hours before your appointment (we recommend 1gm paracetamol and 400mg nuerofen together). Please make sure you are not allergic to these.

Your doctor will explain the procedure to you before hand and you will have enough time to ask any questions. The procedure may take up to 20 minutes and there will always be a nurse with you during the procedure.

• You will be asked to lie on a special couch with stirrups.
• The doctor may or may not use a speculum.
• In most patients local anaesthetic is not required.
• A thin telecope is gently introduced into the vaginal and into the cavity of the womb. Water will be used to distend the womb during the procedure. You will therefore feel the water going through the vagina. When the cavity is been entered, you may experience mild cramps. This disappears quickly after a few minutes of completing the procedure.
• Remember that this is a very simple and quick procedure.
• If at any point you want to stop – you can tell us as you are always in control.
• After the procedure the doctor may wish to do a biopsy from the lining of the womb.
• If you need to have an intra uterine device fitted in- this can be done at the same time.

Inpatient / Day case Hysteroscopy

In some circumstances you may need or request a hysteroscopy under a light general anaesthetic. This can be to remove polyps or fibroids, to find a “lost coil” or if the outpatient procedure was too uncomfortable.

Complications

More than 95% of patients undergo this procedure wihout any problems.
Some patients experience pain/ cramps
1 in 200 patients may feel faint. We always advice that you bring someone with you during the procedure. Very rarely there could be other complications like infections and trauma to the cervix and womb.

Endometrial Ablation or resection

Please see the RCOG guideline