Hysteroscopy

A hysteroscopy is an examination of the inside of the womb (uterus). This is done using the hysteroscope, a narrow telescope about the size of a drinking straw, which can be passed through the cervix (neck of the womb) so that the gynaecologist can see into the uterus. Sometimes a tiny video camera will be fitted over the eye piece of the hysteroscope so that the view can be seen on a video screen by the doctor and the assistant, and by the patient if she is awake and wants to see this.

Diagnostic Hysteroscopy

This is the use of hysteroscopy to determine the cause of a gynaecological problem. This examination may be done if the uterine problems are suspected because of:

  • Heavy or Irregular Periods
  • Postmenopausal Bleeding
  • Infertility
  • Recurrent Miscarriage
  • Unexplained Pain
  • Fibroids

Hysteroscopy may also be performed:

  • To check the results of uterine surgery
  • To check or remove an intrauterine contraceptive device

How is a hysteroscopy done?

Hysteroscopy takes only a few minutes and will be performed without general anaesthetic. Local anaesthetic may be injected into the cervix, but for many women who have had children, this is not necessary. With the use of local anaesthetic some period-type cramps may be experienced. The examination is performed with the woman lying on her back with her legs apart. A speculum, an instrument used for keeping the walls of the vagina apart to allow the cervix to be seen is used. If local anaesthesia is used, it is then injected into the cervix. The cervical opening is gently stretched and the telescope passed through. Usually carbon dioxide gas (or sometimes liquid) is passed through the hysteroscope to distend the uterine cavity a little so that it is possible to see. Without this their front wall sits against the back wall of the uterus, and nothing can be seen.

The shape of the uterine cavity and any irregularities can be seen, as well as the openings of the fallopian tubes and the type of uterine lining. A tissue sample (biopsy) may be taken for examination in a laboratory if necessary.

After the hysteroscopy

It is quite common to need simple pain relief and to have some vaginal bleeding for a couple of days after the hysteroscopy.

Risks

Diagnostic hysteroscopy is a very minor procedure and the risk of serious complication is extremely small. It should not be done if the woman is pregnant or has an infection.