Hysteroscopy

What is a hysteroscopy?

A hysteroscopy is a common gynaecological procedure, placing a thin camera through the cervix to evaluate the inside of the uterus (the endometrial cavity). This may be as an investigation or a treatment.

How is it the procedure performed?

The uterus is filled with a clear fluid (saline) and clear views of the uterus obtained. Polyps and fibroids may be removed, IUDs placed (or removed), the endometrium ablated, or a septum resected.

Generally a hysteroscopy is a day-case procedure, meaning the patient goes home the same day. Depending on the case and the patient, it may be performed under general anaesthetic (asleep), under light sedation, or awake using local anaesthetic (office procedure).

Further reading

Further information

Symptoms

Bleeding after sex

Post-coital bleeding usually occurs within 24 hours of intercourse. In most cases it is nothing to worry about, but should be investigated if persistent or if you are concerned. Common causes are cervical polyps and cervical ectropion. An uncommon cause is cervical cancer. Find out more

Bleeding between periods

This is quite common, and if you experience just a single episode you need not be overly concerned. Common causes are oral contraceptives and other hormonal therapies. Persistent bleeding may be caused by genital tract infections, polyps within the uterus or cervix, or possibly cervical cancer. Find out more

Heavy periods

Typically women may menstruate (bleed) for 2-5 days, and lose around 30-40ml of blood. Abnormally heavy bleeding is when: your periods last longer than 7 days; the volume is more than 80ml; there is flooding or clotting; you are anaemic. Find out more

Irregular or unscheduled bleeding

There are a number of causes of irregular bleeding, and our investigations will depend a bit on your age and fertility plans. Common causes can include endometriosis, infection, instability of the lining of the womb, ovarian cysts, perimenopause, polycystic ovarian syndrome, polyps, and early pregnancy. Find out more

Postmenopausal bleeding

Any bleeding in the menopause is abnormal and needs to be investigated. It is most often caused by fragile tissues (vagina, endometrium) due to lack of estrogen production. Endometrial hyperplasia and cancer may be the cause in 5-10% of cases, and if promptly attended to, treatment is highly successful. Find out more

Prolonged periods

If your period lasts more than 7 days, you have prolonged bleeding. The term is often used synonymously with menorrhogia (heavy bleeding), but is more descriptive of periods that go on for an annoyingly long time. Find out more

Conditions

Polyps

Polyps are common benign growths in the uterus, cervix or vagina. Cervical polyps can cause bleeding after sex. The chances of a cancer being present in a polyp is low, with older women being more at risk than younger women. Find out more

Hyperplasia and uterine cancer

Endometrial hyperplasia occurs when the inside lining of the uterus (the endometrium) starts to behave abnormally. Whilst not cancer, endometrial hyperplasia is a potential 'pre-cancer'. Risk factors include being over 35, obesity, cigarette smoking and polycystic ovarian syndrome. Find out more