Hysteroscopy

What is a hysteroscopy?

A hysteroscopy involves the insertion of a telescope camera through the cervix (neck of womb) into the uterus, with fluid instilled inside the uterus to open up the uterine cavity. This allows diagnosis (and in some cases, treatment) of abnormalities of the uterine cavity and lining. 

Hysteroscopy is frequently performed to achieve a diagnosis when the following gynaecological conditions are suspected:

• Endometrial polyps
• Submucous uterine fibroids
• Abnormal shapes of uterine cavity e.g. septate or bicornuate uterus 
• Asherman’s syndrome (scar tissue involving uterine cavity)
• Infertility/ recurrent miscarriages
• Difficulty in cannulating the uterus (e.g. for fertility treatments)

Hysteroscopy can also be used to treat some of the above conditions when combined with other procedures such as polypectomy (removal of endometrial polyps), excision of fibroids/septum, division of scar tissue, dilation and curettage etc. 

Hysteroscopy is generally a safe and commonly done procedure. 

Risks of hysteroscopy include:

Common risks:

• Vaginal bleeding and discharge – this may last up to 1-2 weeks 
• Pelvic discomfort or pain 

Uncommon but potential serious risks:

• Pelvic infection
• Failure to visualise the uterine cavity
• Asherman’s syndrome
• Uterine perforation (<1%): this may require a laparoscopy (keyhole) or laparotomy (open) for repair and to check for injury to bowels/bladder/blood vessels
• Failure to complete intended procedure (e.g. if polyp/fibroid/septum is large)
• Fluid overload 
• Anaesthetic complications

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