Office Hysteroscopy

What is a hysteroscopy?

A hysteroscopy is an examination of the uterus using a thin telescope called a hysteroscope. Access to the uterus is gained using an instrument called a speculum will be inserted into your vagina to display the cervix, as in a pap smear test. Saline is used to expand the cavity and provide better vision. Your surgeon can then visualise any abnormalities via a monitor, and will show these to you, if you wish. Fine instruments can be passed down the operating channel of the scope in order to obtain a biopsy sample, divide minor adhesions or remove abnormal tissue such as polyps. 

An office hysteroscopy is often performed to investigate symptoms such as; 

  • Heavy or unusual bleeding
  • Postmenopausal bleeding
  • Absent periods
  • Repeat miscarriages or difficulty conceiving

We use office hysteroscopy to diagnose and sometime treat minor adhesions and as a proof of cure after surgery for more extensive adhesions.

Office hysteroscopy usually takes between 15-20 minutes but will depend if the consultant sees any abnormalities, and how the abnormalities are treated. There is no sedation or GA, so you can you can eat and drink as normal and drive to and from your appointment if you wish. If the cervix is stenosed (narrow and scarred) we may need to dilate it. This can make you feel quite faint and nauseous so please don’t have a large meal directly before the procedure.
Unless directed otherwise by your consultant, continue to take your other normal medications.

There is no requirement to be accompanied, but some support is often appreciated.

On the day of your procedure

You will be asked to arrive at the time specified on your confirmation letter. It is usually best to have a comfortably full bladder. 

Please do a home urine pregnancy test the day before your hysteroscopy. 

Although every effort is made to minimise waiting times, occasionally delays do occur and a form of entertainment (a book or a tablet) may make the time pass more comfortably. You will have access to free Wi-Fi. 

After receiving all of the relevant information about the procedure and once you decide to go ahead, your consultant will ask you to sign a consent form to confirm that you agree to have the procedure and that you understand what it involves. 

What happens after my procedure? 

You will be offered a cup of tea or coffee and a biscuit and monitored for 15-30mins, until you are comfortable and feel well enough to go home. 

What should I expect after my procedure? 

Side effects of your procedure: 

  • Bleeding: You may experience some bleeding for a few days after your surgery and if so it might be at its heaviest in the initial 24hrs following your hysteroscopy and is expected to be spotting to a light period level. After this, the bleeding should subside but you may continue to have some light spotting. It is advised that you use sanitary towels and avoid tampons for 1 week following your procedure day.
  • Pain: You are likely to experience some pelvic discomfort, similar to menstrual cramping. Your doctor or nurse will advise you fully on how to manage this. Paracetamol s usually sufficient to manage any pain, but if necessary your consultant will prescribe some medication for you to take home.
  • You may also find yourself feeling more fatigued than usual for the remainder of the day.

Risks & Presentation 

Office hysteroscopy is a very safe procedure, but as with all surgery, there are some risks associated with this procedure. They are however, very small and uncommon. The most likely problem is infection. We always give an antibiotic at the time of surgery, but if you develop any of the following symptoms do call the office number 0207 486 2440 or seek help from a local doctor.  if there is no-one in the office you will be directed to an emergency mobile number. if you cannot reach a doctor on this number you should call 111 or go to your nearest accident and emergency department.

  • Temperature of 38.0 or higher
  • Fever/chills
  • Discharge which has an unpleasant odour
  • Joint pain
  • Abdominal swelling
  • Nausea or vomiting

Heavy vaginal bleeding is unlikely to occur, but if it does and you are worried, please call the office or the emergency number after hours.

Very rarely the hysteroscopre may penetrate the wall of the uterus or create a false passage. This should not happen, but if it does we will be aware of it at the time of surgery. Most cases can be managed conservatively with a few days of antibiotics. Exceptionally, it may be necessary to admit you for further care or observation and possibly a laparoscopy.

If you notice any of the above symptoms or have any urgent queries as an emergency, please contact our office on 020 7486 2440 where, if after office hours, an emergency number is given.