A gynaecologist performs a hysteroscopy to examine the uterus and cervix, which enables them to have an up-close view and see what may be causing menstrual or infertility problems. If you have been told that you need to have the procedure, you may be wondering what to expect both on the day and just after. Thankfully, one of our specialists Mr Andrew Baxter is here to explain everything.
What is a hysteroscopy?
A hysteroscopy involves the insertion of a narrow telescope through the neck of the womb to inspect the inside of the uterus. The telescope has a camera on the end which allows the doctor to see the findings on a monitor.
Why is hysteroscopy performed?
Hysteroscopy is really useful in the following situations:
- In women who have experienced post-menopausal bleeding (this is any vaginal bleeding that occurs 12 months or more after your last menstrual period), irregular periods or spotting between periods
- To investigate an abnormal ultrasound finding such as fibroids or polyps
- To retrieve a ‘lost’ coil when the threads can’t be seen on examination
- To plan the best treatment for heavy menstrual periods
- To investigate possible causes of infertility and/or recurrent miscarriage
Where is it performed?
Most hysteroscopies are undertaken in the out-patient department as a ‘walk-in/walk-out’ service.
However, women can choose to have a general anaesthetic (GA) for their procedure if they prefer. If you have experienced significant discomfort, or have felt faint with having a cervical smear or examination in the past you may prefer to have the procedure under GA. This will require a day case admission to hospital.
What does hysteroscopy involve?
You will be sent an information leaflet on the procedure with your appointment or you may well have been given written information by the doctor at your previous consultation. As most procedures are performed in outpatients women are encouraged to eat and drink as normal and indeed it is preferable to have eaten prior to coming to the clinic.
On arrival, you will be admitted to the clinic by the nursing team. They will check your basic observations (pulse, blood pressure and temperature) and it is routine to perform a pregnancy test in all patients under 55 years of age.
Your doctor will then discuss what the procedure involves as well as the potential risks. The doctor will then ask you to sign a consent form once you have had time to ask any questions and will be asked to remove your clothes from the waist down and put on a theatre gown.
You will be taken into the procedure room where there will be two nurses. One nurse is there, primarily to look after you, with the other mainly helping the doctor. Following this, you will be asked to sit on a couch with your legs up in supports. The procedure uses water so it is important to ensure that you are not sat on your clothes to prevent them getting wet!
The surgeon then inserts the hysteroscope, which is only 2-4mm wide, into your vagina. At that point, you will be aware of the water that is being used to allow the surgeon to pass the scope through the neck of the womb into the womb cavity.
In most cases, the procedure does not require the use of a speculum (the instrument used to take smears) or anything to hold the cervix. Once the inside of the womb has been inspected, photographs of the findings will be taken for your notes and, in many cases, a small biopsy is taken from the lining of the womb with a narrow suction device.
How long does it take?
The procedure itself takes no more than five minutes, with the entire hospital visit generally being under an hour.
What should I expect after a hysteroscopy?
You will be offered a hot drink after the procedure and will be fine to drive home yourself when you feel up to it, usually after 30 minutes.
You might continue to have some crampy pains for a few hours afterwards and you might need another dose of pain-killers six hours after the first. This discomfort has generally passed in one to two days. Any spotting should settle within a few days.
If you experience heavy bleeding, increasing abdominal pain, a raised temperature or a vaginal discharge please contact the clinic or your GP immediately. You can get back to normal activities and sexual intercourse when any bleeding has stopped and you feel up to it.
You will receive the results from any biopsy taken within two weeks and you will be seen back in clinic thereafter to discuss further management.
You can book an appointment with Mr Baxter via his Top Doctor’s profile here for any of your gynaecological needs.