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APPOINTMENT

Endoscopy

Hysteroscopy?

What is a Hysteroscopy?

A hysteroscopy is an examination of the inside of the uterus (womb). This is done by using a hysteroscope, a narrow telescope, which can be passed through the vagina, through the cervix (neck of the womb) and into the cavity of the uterus.

This is usually a simple procedure. It is usually performed under short general anesthesia in operation theatre. The hysteroscope is attached to a camera and television system so that the inside of the uterus can be clearly visualized on screen by the doctor.

Hysteroscopy

Usually normal saline is used for distension of uterine cavity during hysteroscopy. Once distended, the shape of the uterine cavity and any irregularities can be seen, as well as the openings of the fallopian tubes.

  • There are many reasons why females need a hysteroscopy.
  • The most common reasons include:
  • Infertility to rule out any intrauterine pathology like septum, adhesions (asherman syndrome), fibroids, polyps.
  • Tubal cannulation for fallopian tube blocks.
  • Women with repeated miscarriages
  • To perform procedures like endometrial biopsy, myomectomy for submucosal fibroids, polypectomy, septum resection, tubal cannulation for fallopian tube blocks, adhesiolysis, and examination of uterine cavity before embryo transfer.
  • Heavy or irregular periods
  • Post-menopausal bleeding
  • Removal of intrauterine devices when thread is not visible

Pain during or after hysteroscopy is usually mild and similar to period pain. Simple pain relief medications can help. On occasion, women may experience severe pain.

Feeling or being sick or fainting can affect a small number of women. However, these symptoms usually settle quickly.

Bleeding is usually very mild and is lighter than a period, settling within a few days. It is recommended that you use sanitary towels, not tampons. If the bleeding does not settle and gets worse, contact us.

Infection is uncommon (1 in 400 women). It may appear as a smelly discharge, fever or severe pain in the tummy. If you develop any of these symptoms, contact us urgently.

Failed/unsuccessful hysteroscopy occurs if it is not possible to pass the hysteroscope inside your uterus. Usually this happens when the cervix is tightly ‘closed’ or scarred. If this happens, we will discuss alternative options with you.

Damage to the wall of the uterus (uterine perforation) rarely, a small hole is accidentally made in the wall of the uterus. This could also cause damage to nearby tissues. This happens in less than 1 in 1000 diagnostic hysteroscopy procedures, but is slightly more common if someone has a polyp or fibroid removed at the same time. It may mean that you have to stay in hospital overnight. Usually, nothing more needs to be done, but you may need a further operation to repair the hole.

Fluid overload complications such as subsequent hyponatremia, hypo-osmolality, hypothermia, pulmonary edema, cerebral edema are rare but can occur in few cases.

It is important that you have all the tests, which we have ordered, prior to coming to hospital. It is necessary that you have nothing to eat or at least six hours before your operation. Follow the instructions given by us.

The actual procedure may only take 10–15 minutes. However, the total visit may take up to 1-2 hours including consultation, having the procedure, recovery and discharge.

If polyps or small fibroids are removed at the same time, this may take a bit longer.

You can rest in the outpatient clinic’s recovery area for as long as you need (usually about 20 minutes).