What is a hysteroscopy?
A hysteroscopy is an examination of the inside of the womb using a very small telescope and camera. A hysteroscopy is useful as it allows the doctors and nurses to look closely throughout the womb. Biopsies can be taken and, if needed, small treatments can often be performed at the same time.
Anyone who has a hysteroscopy needs to sign a consent form. Your nurse or doctor will explain the procedure in full and discuss the possible side effects.
This leaflet is intended to answer any questions you may have about the procedure. If you have further questions or concerns, please do not hesitate to ask a member of staff.
What is a hysteroscopy for?
Hysteroscopy is useful for:
- Finding out what is causing symptoms such as heavy periods or postmenopausal bleeding
- Investigating problems such as difficulty in getting pregnant
- Diagnosing conditions of the endometrium (lining of the womb) by taking a biopsy (small sample of tissue) for examination in the laboratory
- Treating some conditions by passing narrow instruments through the hysteroscope. It may be possible to remove polyps or fibroids (small lumps of tissue that can grow from the womb lining) as well as intra-uterine contraceptive devices (IUCD’s, commonly known as coils) that are otherwise difficult to remove.
Are there alternatives to a hysteroscopy?
A scan can provide an assessment of the shape and size of the womb and can also measure the lining of the womb (endometrium). A pipelle biopsy, which involves passing a small straw inside the womb, and sometimes be used to take a small sample from the lining of the womb to test but it may not examine the entire lining of the womb. A hysteroscopy provides the most information and can also be used to treat problems at the same time.
Do I need to do anything to prepare for clinic?
Hysteroscopy is usually performed using local anaesthetic in the Women’s Health Unit. You can eat and drink as normal and take all of your regular medications. Please bring a list of medications, allergies and details of any past or current health problems with you.
The clinic is often busy and you may be in the hospital for a few hours. We recommend that you bring a drink and a small snack with you for this reason.
It can be beneficial if you have taken simple painkillers, such as paracetamol and ibuprofen (please read the instructions on the packet), one to two hours before your appointment.
Hysteroscopy may be performed in the Women’s Health Unit under ‘conscious sedation’ with an anaesthetist or in an operating theatre under general anaesthetic. If this is the case you will be need to be seen in the pre-assessment clinic in preparation and you will be given specific instructions to not eat and drink for 6 hours before surgery.
Who will see me at the clinic?
You will meet a number of people at the clinic including a consultant or registrar doctor, nurses, student nurses and doctors and, sometimes, a research nurse. When you arrive at the clinic, you will be seen by a nurse who will ask some simple questions about yourself and take some measurements, including your height and weight.
You will then speak to a doctor who will ask about your symptoms and your general health. Please bring a list of any medications and previous health conditions or surgeries with you.
Our team of doctors, nurses and students are male and female but there will always be a female nurse with you at all times during the hysteroscopy.
What happens during the procedure?
Hysteroscopy is usually performed as an outpatient or day case procedure in the Women’s Health Unit. The procedure usually takes around 15 – 20 minutes.
You will be asked to lie on the bed and to use leg stirrups. Local anaesthetic can be used to make the cervix (neck of the womb) numb to make the procedure more comfortable. Once the anaesthetic has taken effect, the hysteroscope is gently passed through the cervix into the womb. It is attached to a small camera so that pictures appear on the screen. During the procedure, there is a continuous flow of fluid through the hysteroscope to create a clear view. After the examination, the hysteroscope is removed quickly and easily. The doctor will often take a small biopsy (a pinch of tissue) from the womb and if a polyp (growth of tissue) is seen, this can often be removed at the same time.
The procedure can be uncomfortable and some women may use some Entonox (‘gas and air’) to help with discomfort. The procedure can be stopped at any time. You will have a nurse with you throughout the procedure.
Are there any side-effects or risks of a hysteroscopy?
Hysteroscopy is a commonly performed and generally safe procedure. In order to be able to give consent, anyone deciding whether to have this procedure needs to be aware of the possible side effects and the risk of complications. Your doctor will be able to explain how the risks apply to you. You will be asked to sign a consent form to confirm that you agree to have the hysteroscopy.
Side effects
Side effects during and immediately after the procedure are common but are usually mild and temporary . Women often have:
- Abdominal pain, often described as similar to period pain
- Vaginal bleeding for several days, although, occasionally, bleeding and discharge can continue for up to a month.
Risk of complications
Complications are unexpected problems that can occur during, or after, the procedure. Most women are not affected. Your doctor will be able to explain how the risks apply to you.
Possible complications of any procedure are:
- Bleeding during, or soon after, the procedure
- Infection
- An unexpected reaction to the anaesthetic
Uncommon complications of hysteroscopy:
- Feeling faint – this affects 1 in every 200 woman who have a hysteroscopy with either no anaesthetic or local anaesthetic
- In a few cases, the hysteroscopy may not be successfully completed and will need to be repeated
- Accidental damage to the womb. This can lead to bleeding and infection, which may require treatment with medicines, a further operation or, in an extreme case, a hysterectomy (removal of the womb)
- Accidental damage to the cervix – this is rare and can usually be easily repaired.
What to expect after a hysteroscopy?
As the anaesthetic wears off, there may be some abdominal or pelvic pain and simple pain relief may be needed. Following a local anaesthetic, women usually feel ready to go home after a short rest in the clinic.
You can eat and drink as normal straight away. Many women, even following a biopsy, will be able to drive but some women will choose to arrange for transport with a friend or family member.
Once you are home, simple pain relief may be taken if needed. Many women feel able to return to normal activities or work the day after the procedure. Others may need to take 1 – 2 days off.
Light bleeding or spotting for a few days is normal. Some women find that the first period following the procedure is heavier or more prolonged than usual. To help avoid the risk of infection, avoid tampons or intercourse for at least one week after a hysteroscopy.
Most women experience no medical problems after a hysteroscopy. The hospital or GP should be contacted immediately if any of the following symptoms develop as they may be a sign of an infection or a complication:
- Persistent heavy bleeding
- Pain that persists for more than 48 hours
- Swollen abdomen or general abdominal pain
- High temperature or fever
Please contact your GP who will be able to help in most cases. If, however, you cannot reach your GP, staff at the Women’s Health Unit or our Gynaecology Ward may be able to offer advice over the telephone.
Contact
Women’s Health Unit (Monday to Friday, 8:30am – 5pm):
Ward 40 (24 hours):
When will I get the results?
Test results (from extra scans and biopsies) typically take 4 weeks to be reported to your doctor. Your doctor will write to you with the results quickly after this.
What should I do if I have not heard about my results?
Typically, you will receive the results within 4 weeks of the procedure. If you have not received a letter or phone call from us within this time frame, please contact us.
Call our secretarial team on: 0191 282 5031
- Miss Rachel O’Donnell’s secretary – Option 6
- Mr Tony Chalhoub’s secretary – Option 3
- Miss Michelle Russell’s secretary – Option 4
Research
At the RVI, we have a large research team and often work with Newcastle University. All of our consultant team are actively involved in research and may discuss the possibility of you getting involved in research at any of our clinics.
Whilst we are very grateful for those who choose to participate, this is not essential and please feel free to decline. This will not affect your care.
What if I cannot attend my appointment?
If you are unable to attend your appointment, please let us know.
Call our secretarial team on: 0191 282 5031
Concerns or complaints
Patient Advice and Liaison Service (PALS)
Should you have any suggestions or concerns, please make these known to a member of the team in the clinic or by letter to the hospital. We welcome suggestions to help improve our services.
The PALS service aims to advise and support patients, families and carers and can help to deal with matters quickly on your behalf. This service is based at the Royal Victoria Infirmary Hospital.
Telephone: 0800 032 02 02
Text: 0781 550 0015
Email: [email protected]
