This procedure allows to immediately examine the uterine cavity with a special camera (a hysteroscope). The doctor can detect possible polyps or fibroids, which can be removed during the examination.
Hysteroscopy is an everyday routine procedure. The patients may leave the hospital soon after the procedure and do not need to stay overnight in hospital. Hysteroscopy is very useful in diagnosing fertility problems.
There are 2 types of hysteroscopy: diagnostic and surgical.
It is performed in order to detect any abnormalities of the uterus that might cause symptoms such as:
• Heavy bleeding during your period or irregular bleeding
• Pelvic pain
• Recurrent miscarriage
During hysteroscopy, the doctor can detect the problem (e.g. a polyp, fibroids or adhesions), treat it (e.g. remove the polyp) or take a biopsy. In that case, hysteroscopy needs to be performed under general anesthesia (mild sedation).
Hysteroscopy cannot be performed if the patient is pregnant, if she has an active infection of the vagina or the urinary tract or if she has uterine cancer.
The best time to perform hysteroscopy is within the first 10 days of the woman’s cycle or later, provided she is certain that she did not just get pregnant. In case of a surgical hysteroscopy, you should not eat or drink anything 8 hours before the procedure because you will be administered general anesthesia. Also, you should start taking antibiotics 2 days prior to the procedure as a precaution. The procedure itself lasts about 10 to 30 minutes, depending on how extensive it is (what must be done).
After the procedure, the patient does not need to stay in hospital and can go home. If general anesthesia has been administered to her, she must stay in hospital for a while, in order for possible side effects from the anesthesia to pass off.
Apart from some mild pain resembling period cramps, usually hysteroscopy does not cause pain. A simple pain killer should be sufficient for these cramps. Most women return to their everyday life, and work the day after the procedure.
If during hysteroscopy the doctor removes polyps, fibroids or adhesions, usually there is some bleeding after the procedure; this is to be expected. Following the procedure, the doctor will inform you about hysteroscopy findings and about whether he removed e.g. a polyp.
So, hysteroscopy generally is a safe procedure. After the examination, the vast majority of women might feel some pain and have some bleeding for 1-2 days. Serious complications are very rare (2 women out of 1.000 who have had the examination):
• Infection of the uterus or the pelvis (to be treated with antibiotics)
• Trauma of the uterus during the examination (e.g. perforation) that might lead to bleeding. In extremely rare cases, further surgical intervention or blood transfusion is required.
As in any surgical operation, it is possible that the woman might experience side effects due to anesthesia or experience bleeding or clotting. The risk of complications is slightly elevated if the patient has had surgery in the uterus or the cervix in the past, if there are other health issues or if she is clinically obese.