Hysteroscopy involves examining the inside of the uterus with a small telescopic camera that is passed through the cervix. Hysteroscopy can either be performed under a general anesthetic, when it is often combined with a D&C, or in the outpatient department. Several types of hysteroscopic procedures have been developed to treat specific problems.

Why Is It Done?

Hysteroscopy is used to examine the inside of the uterus to make sure the lining (endometrium) appears normal, and to check for growths. These may be benign, such as polyps, or malignant. It is an integral part of these investigations to find out the cause of heavy or frequent menstrual periods or bleeding between periods. It is also performed on older women to investigate postmenopausal bleeding.

Hysteroscopy also has a role in removing misplaced or difficult-to-locate IUDs and in the investigation of infertility, to check that the uterus is structurally normal.

How Is It Done?

• The procedure involves passing the hysteroscope into the cavity of the uterus. If the procedure is being performed in the outpatient clinic you may be given pain medication about 1-2 hours beforehand, and occasionally a local anesthetic will be injected in and around the cervix to help relieve any discomfort.
• In order to obtain a good view of the cavity, it has to be distended using either a harmless gas such as carbon dioxide, or liquid. The doctor will visually inspect the inside of the uterus, making a note of any abnormal areas.
• If it is carried out under a general anesthetic, the procedure is often followed by a D&C.
• Other procedures may be carried out using specially adapted hysteroscopes. The lining of the uterus can be burned away to help treat heavy menstrual periods. This is particularly useful if there is no evidence of malignancy, if drug treatments for heavy periods have been unsuccessful, and to avoid a hysterectomy.
• Infertility treatments occasionally use hysteroscopic instruments to divide scar tissue in the uterus and to help correct any congenital structural abnormalities affecting the uterine cavity, including the removal of fibroids within the cavity of the uterus.
• For a few days after a hysteroscopy you may notice some spotting of blood. Most women go home the day of the operation. However, some may be required to stay in the hospital for a few days if the hysteroscopy has been combined with an operative procedure.
• In experienced hands, complications of hysteroscopy are uncommon but they can, rarely, include uterine infection and perforation if an additional procedure is being performed, such as endometrial resection.

What Can I Do?

Make sure that you understand why the procedure is being performed and what will be achieved. Hysteroscopy is usually not performed if you are pregnant and is best avoided if you are suffering from pelvic inflammatory disease.

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