A hysteroscopy is a procedure that involves examining the inside of the uterus (womb). This is done by passing a thin telescope-like device, called a hysteroscope, that is fitted with a small camera through the neck of the womb (cervix). It makes possible to see whether there are some diseases inside the uterus that may need further investigation or treatment. No cuts are needed.

During a diagnostic hysteroscopy the gynecologist will just observe the uterine cavity and, if necessary, might perform an endometrial biopsy (taking a sample from the lining of the uterus). 

On the other hand, during an operative hysteroscopy, the doctor will perform surgery to remove abnormal findings such as:

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• Polyps (skin tag that looks like a small grape, sometimes on a stalk. They are formed as a result of the overgrowth of the lining of the uterus).

• Small fibroids (knots in the muscle of the uterus) 

• Removal of a lost IUD (Intrauterine device) 

 

Pattens are referred for hysteroscopy in case of:

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• Bleeding after the menopause (postmenopausal bleeding) 

• Very heavy periods

• Bleeding between periods

• Irregular bleeding while on hormonal treatment

• Removal of an IUD when the threads are not visible at the cervix

• Fertility concerns

• Following a miscarriage

• To investigate something seen inside the uterus on an ultrasound scan, such as an endometrial polyp or fibroid.

 

 

The procedure is not performed if there is any chance that the patient is pregnant.

It can be impossible to do the procedure if the patient is bleeding heavily and it might become necessary to postpone it.

 

Like every medical procedure or surgery, hysteroscopy has some risks.

• Pain during or after the procedure

• A small number of women feel sick and might faint.

• Bleeding: usually very mild and resolves within a few days. 

• Infection is uncommon. It might cause smelly discharge, fever or severe pain. 

• Failed procedure: when it is not possible to pass the hysteroscope inside your uterus. It might happen if the cervix is tightly ‘closed’ or scarred. Rarely, uterine perforation: a small hole is accidentally made in the wall of the uterus. This could also cause damage to nearby tissues. Usually, nothing needs to be done, but it might be necessary for an operation to repair the hole.

 

 

Sources and acknowledgment

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RCOG/BSGE Green-top Guideline No.59, Best Practice in Outpatient Hysteroscopy, published in March 2011.

 

Outpatient hysteroscopy. December 2018. RCOG patient information  leaflet

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