Hysteroscopy
What is a hysteroscopy?
A hysteroscopy is a minimally invasive procedure that allows your specialist to examine the inside of the uterus using a thin telescope called a hysteroscope.
The procedure is performed through the vagina and cervix, so no abdominal incisions are required. It may be used to investigate symptoms, confirm a diagnosis or perform treatment during the same procedure.
Why might I need a hysteroscopy?
A hysteroscopy may be recommended to investigate or treat a range of gynaecological conditions.
Common reasons include:
- heavy menstrual bleeding
- abnormal vaginal bleeding
- bleeding after menopause
- endometrial polyps
- fibroids within the uterine cavity
- assessment of fertility.
In many cases, hysteroscopy is combined with a curettage, where a small sample of the lining of the uterus is collected for further examination.
Treatment may also be performed during the procedure, including removal of polyps or fibroids, or insertion of a hormone-releasing intrauterine device such as a Mirena.
Your specialist will explain the reason for your procedure and what is planned in your individual case.
How is a hysteroscopy performed?
A hysteroscopy is usually performed under general anaesthesia, but can also be performed under local anaesthesia in the specialist rooms.
After you are asleep:
- an examination is performed
- the cervix is gently dilated
- the hysteroscope is passed through the cervix into the uterus
- the uterine cavity is examined
- any planned treatment or tissue sampling is carried out.
Because the procedure is performed through the vagina, there are no abdominal incisions.
The procedure itself usually takes around 10 minutes, although your total time in theatre and recovery will be several hours.
What should I do before the procedure?
Before your hysteroscopy:
- complete any investigations requested during your pre-operative appointment
- continue your usual medications unless advised otherwise
- stop smoking, if possible, to reduce surgical risks
- contact your specialist if you become unwell before your procedure.
What should I do on the day of the procedure?
Eating and drinking
Unless your specialist advises otherwise, you should stop eating and drinking:
- from midnight before a morning procedure, or
- from 6.00 am before an afternoon procedure.
Your specialist or hospital will provide specific fasting instructions before your surgery.
What should I bring?
Please bring:
- your usual medications
- any recent imaging or radiology
- toiletries
- underwear
- sanitary pads.
What should I expect after the procedure?
When you wake from the anaesthetic, you will spend a short period in the recovery area.
Most people are able to go home later the same day, depending on the procedure performed.
It is normal to experience:
- mild pelvic cramping
- light vaginal bleeding or spotting
- mild discomfort.
If required, your specialist will prescribe pain relief. Otherwise, simple pain medication is usually sufficient.
After you go home
You should:
- eat and drink normally
- remain gently active
- use sanitary pads rather than tampons if required
- shower as normal.
For approximately two weeks, you should avoid:
- sexual intercourse
- swimming or spa baths if advised by your specialist.
You should also avoid driving, operating machinery or making important decisions on the day of your procedure because of the effects of the anaesthetic.
Most people return to work the following day, although this varies depending on the treatment performed.
What are the risks of this procedure?
Every surgical procedure carries some risk, although serious complications following hysteroscopy are uncommon.
Potential risks include:
Anaesthetic risks
As with any procedure performed under anaesthesia, there is a small risk of complications related to the anaesthetic itself.
Surgical risks
Although uncommon, the procedure may result in:
- perforation of the uterus
- injury to surrounding organs or blood vessels
- bleeding requiring further treatment or surgery.
Recovery-related risks
Potential complications during recovery include:
- infection involving the uterus, bladder or pelvis
- blood clots in the legs or lungs
- nausea or vomiting
- unexpected pain requiring overnight admission
- delayed recovery.
Your specialist will discuss any risks that are particularly relevant to your individual circumstances before the procedure.
What if I have any problems?
Contact your healthcare provider promptly if you develop:
- fever or feel generally unwell
- heavy vaginal bleeding
- offensive-smelling vaginal discharge
- severe pelvic pain
- persistent nausea or vomiting
- difficulty emptying your bladder or bowels.
What can I expect?
A hysteroscopy is one of the most commonly performed gynaecological procedures and is generally very safe.
For many women, it provides valuable information about the cause of symptoms such as abnormal bleeding or infertility, while also allowing treatment to be performed during the same procedure.
Recovery is usually quick, with most people returning to normal activities within a day or two.
What to remember?
A hysteroscopy is a minimally invasive procedure used to diagnose and treat conditions affecting the inside of the uterus.
Because no abdominal incisions are required, recovery is generally straightforward. Your specialist will explain exactly what is planned during your procedure and discuss any findings or treatment afterwards.
Further information
Additional information about hysteroscopy is available through the Australasian Gynaecological Endoscopy & Surgery Society (AGES).
This article is intended for educational purposes only and should not replace personalised medical advice, diagnosis or treatment. Every article is written by a qualified specialist clinician and independently reviewed by a second specialist clinician to help ensure clinical accuracy and reflect current evidence-based practice.
