In the past a procedure called dilatation and curettage was commonly used to examine the womb (uterus), but nowadays a hysteroscopy is the preferred method for investigating symptoms emanating from the uterus.
The procedure is performed using a hysteroscope which is a narrow telescope with a light and camera on the end. It is passed into the womb through the cervix meaning and no surgical cuts are necessary. The hysteroscope sends images to a monitor so a gynaecologist can see into the uterus.
Reasons a hysteroscopy may be performed
A hysteroscopy is used to investigate the cause of heavy or abnormal periods, postmenopausal bleeding, pelvic pain, repeated miscarriages or difficulty getting pregnant. It is also used to diagnose and treat conditions like fibroids and other benign growths.
Removing fibroids and other growths, treating scar tissue that can affect fertility (intrauterine adhesions) or resolving problems like displaced IUDs can be done via a hysteroscopy as well.
A hysteroscopy is a short day procedure which mostly is performed under sedation or general anesthetic in Australia. However, it may be done with local anesthetic under some circumstances. Generally, it is performed on an outpatient basis so no overnight stay is required.
The position taken is similar to a pap smear where the patient’s vagina is held open using a speculum and the hysteroscope is passed into the uterus. As it passes through fluid is pumped inside to improve visibility for the gynaecologist. The camera on the hysteroscope will send pictures to a monitor so a diagnosis can be made or treatment performed.
This procedure can take up to 30 minutes if treatment is required or scheduled. If the hysteroscopy is just investigative or diagnostic it may only last around 5-10 minutes. It should not be painful, but it may cause some discomfort similar to menstrual cramps. The outcome or results of the hysteroscopy are discussed before the patient leaves the facility.
Most women are able to return to their usual activities the same or next day. If general anaesthetic was used then the patient should not drive or go to work for 24 hours post anaesthetic.
Spotting or bleeding for a few days after the procedure is normal and is only concerning if the bleeding is heavy. A feeling not too dissimilar to menstrual cramps is also common. After a hysteroscopy sex should be avoided until after bleeding has stopped . This will help reduce the risk of infection.
What are the risks of a hysteroscopy?
Hysteroscopies are very safe, but like any medical procedure there are small risks of complications, which are higher amongst women having treatment than it is for an investigative procedure.
Some of the minor risks include feeling faint, which affects less than 1% of women who have the procedure without a general anaesthetic. It is common to have some postprocedural bleeding. Womb infection is uncommon but possible and can cause pungent discharge, heavy bleeding or a fever, but is easily treated with a short course of antibiotics.
Other slightly more serious risks include accidental damage to the womb requiring antibiotic treatment, usually in hospital, or another operation, however this is extremely uncommon. Damage may be accidentally caused to the cervix, but this too is rare and can be repaired.
At Northside Gynaecology we will only perform a hysteroscopy if it is clinically indicated and the benefits outweigh the risks. If you would like to know more about this procedure and how it could diagnose or treat symptoms you currently have, please get in touch on 1300 780 138 to book an appointment with one of our experienced doctors.