• Reference Number: HEY7322024
• Departments: Gynaecology
• Last Updated: 1 March 2024

Introduction

This leaflet has been produced to give you general information about your procedure.  Most of your questions should be answered by this leaflet.  It is not intended to replace the discussion between you and your doctor, but may act as a starting point for discussion.   If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team caring for you.

What is a hysteroscopy?

You have probably been troubled by a number of symptoms and following a discussion with your doctor, you have been advised that you will need to undergo a hysteroscopy.

This is a procedure that allows a doctor to look directly into your womb. A thin telescope called a hysteroscope is passed gently through the cervix (the neck of your womb) into the womb itself. A television camera can be attached to the hysteroscope, so that the doctor will be able to see inside your womb. At this stage, any disease or abnormality can be seen and a biopsy (a sample of tissue) may be taken if required.

What are the benefits of having a hysteroscopy?

A hysteroscopy is performed for several reasons, these include:

• Heavy or irregular bleeding that has not improved with tablets prescribed to you by your doctor.
• Bleeding in-between your periods.
• Bleeding more than 1 year after menopause.
• Irregular bleeding whilst you have been taking Hormone Replacement Therapy (HRT).
• If you are thinking about having an operation to make your periods less heavy (Endometrial ablation or microwave ablation).

Can there be any complications or risks

The risks associated with this procedure are minimal, however the risks that may occur include:

• The risk of a small hole being made in the womb and subsequent infection.
• The neck of the womb may be too tight to allow the passage of the telescope.  In this case, a hysteroscopy under general anaesthesia may be needed, which will be booked for another date.
• Some women may experience excessive discomfort during the procedure and in this case the procedure would be abandoned.
• Bleeding.
• Damage to the uterus.
• Damage to bowel, bladder or major blood vessels.
• Failure to gain entry to uterine cavity and the ability to complete the procedure.
• Infertility.

The overall risk of serious complications from a diagnostic hysteroscopy is approximately 2 in 1000 women.

How do I prepare for a hysteroscopy?

Please read the information leaflet and share it with your partner and family (if you wish) so that they can be of help and support.  There may be information they need to know, especially if they are taking care of you following this procedure.

You will need to abstain from having sexual intercourse from the first day of your last period until your procedure. This includes intercourse using any form of contraception or protection such as condoms. Should you have sexual intercourse within this period, your hysteroscopy will not go ahead. Please do not be offended when the nurse and doctors ask personal questions regarding your period and sex. This information is needed to ensure your safety during the procedure.

No babies or children are allowed in the waiting area or department due to the sensitive nature of the services we provide. You will therefore need to make arrangements for your family/children prior to your procedure. 

To alleviate any discomfort during and after the procedure it may helpful if you take some pain relief 1 to 2 hours before your appointment. Pain relief such as Ibuprofen is preferable.

You will be asked for a urine sample prior to the procedure to test for infection or potential pregnancy.

What will Happen?

When you come to the department, the doctor will explain the procedure to you. At this stage, if there are any questions that you would like to ask about the procedure, please do so. 

You need to inform the doctor if you have any allergies or have had any bad reactions to drugs or other tests in the past. They also would like to know about any previous surgery or operations you have undergone.

You will then be asked to remove all clothing from your waist down. A nurse will be with you throughout the whole of the procedure and you will be made to feel as comfortable as possible on either an examination couch or chair.  You will then be asked to rest your legs on two leg supports.

An instrument, which is the same sort of instrument which is used when you have a smear test, is then inserted into your vagina.  This is to allow the doctor to see the neck of your womb. Sometimes a little local anaesthetic is injected into the neck of the womb. The hysteroscope is then gently placed close to the outer opening of the neck of your womb. Fluid is passed, through the hysteroscope as it slowly passes through the neck of your womb, into your womb.

If you wish you are able to watch the process on the nearby television screen. If you do not wish to see the screen please let the doctor or nurse know.  At this point the doctor may wish to take some images however you will be asked to give your consent before these are taken.

During the procedure you may experience cramps within the lower part of your tummy, this can be likened to period pain. These will settle after the procedure has finished.

A biopsy of the lining of the womb may also be taken at the end. If you find this part of the procedure uncomfortable, please inform the doctor or nurse. Any findings identified during the procedure can be explained at the time and please do not hesitate to ask the doctor or nurse for any information or clarification.

Some women do feel faint after the procedure, if this happens you will be asked to rest on a recliner chair.  You may also experience a dull ache which can last for a few hours after the produced.  By taking pain relief this will usually help.

The whole procedure is likely to take about 10 minutes.  It is only natural for you to worry about the procedure and most women are surprised that it is completed rather quickly.

There may be occasions in which we are unable to pass the hysteroscope into your womb and this will mean that the procedure will have to be abandoned. If this is something that happens during your procedure, the doctor will fully explain what further options are available to you.

What happens afterwards?

After the procedure you will be asked to rest in a nearby waiting area where you will be offered a drink. You may eat and drink normally after the procedure.

It is a good idea to bring your partner or friend to accompany you home to provide you with support. However you can drive yourself home after the procedure as you have not been administered any drugs.

It is likely that you will experience minimal vaginal bleeding for a day or so after the procedure.  During this time we would advise that you do you use tampons, engage in sexual intercourse or go swimming until any bleeding has stopped. If your bleeding becomes heavier (than a normal period) or you have a discharge which is offensive smelling then you should contact your GP for advice.

When will I know my results?

Immediately after the examination the doctor will explain the findings to you.  If a biopsy is taken or you have had a polyp removed at the time of the procedure, it will be several weeks before the results are available. You may have your results sent to you by letter or you may receive a follow up appointment.

Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact the Gynaecology Outpatient Department, Women and Children’s Hospital on tel: 01482 607829.