17 February 2020
Why would a patient need a hysteroscopy procedure?
Hysteroscopy may be necessary to diagnose abnormalities in the womb. This may be required during investigations of heavy periods, bleeding in between periods, infertility, unexpected cessation of periods, recurrent miscarriages or post-menopausal bleeding. The expected abnormalities can include endometrial polyps, fibroids, adhesions, cancer or developmental abnormalities of the womb.
What happens during the hysteroscopy procedure?
Hysteroscopy involves passing a telescopic camera (a hysteroscope) into the womb to examine the inside of the womb. This may be done under a local anaesthetic or a general anaesthetic. The local anaesthetic is performed by injecting an anaesthetic injection into the cervix to numb it. This is because the stretching of the cervix by the passing hysteroscope can be painful. The choice of anaesthetic is personal preference but recovery from local anaesthetic is much quicker.
Does my menstrual cycle affect when I can have a hysteroscopy?
Ideally, hysteroscopy is not done when the patient is experiencing her period to get better views of the womb. The second half of the menstrual cycle (ie within two weeks before a period) is better if a biopsy is also planned as the endometrium (lining of the womb) is thicker at this time. However, care must be taken to ensure that pregnancy is not a possibility.
Are there risks associated with a hysteroscopy?
There are uncommon risks such as minimal trauma to the cervix or sometimes trauma to the wall of the womb. This can result in some bleeding (often not worrisome) or infection. Complications are less likely if hysteroscopy is performed by experienced clinicians.
Are there alternatives to hysteroscopy that are equally as efficient?
An ultrasound scan of the pelvis (both with an abdominal and transvaginal probe) is very informative to suspect most of the abnormalities within the womb but hysteroscopy remains the gold standard investigation of choice.
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