Office hysteroscopy or out-patent hysteroscopy is a minimally invasive procedure that allows your gynaecologist to examine the inside of your uterus (womb) using a thin, lighted telescope (hysteroscope). It is performed in a clinic setting, without general anaesthesia, to diagnose or treat uterine conditions.
Your Gynaecologist may suggest this procedure if you have:
- Abnormal uterine bleeding (heavy periods, postmenopausal bleeding)
- Repeated miscarriages or infertility
- Suspected polyps, fibroids, or adhesions (scar tissue)
- Abnormal ultrasound/MRI results
- Removal of a displaced intrauterine device (IUD)
This procedure is not suitable if:
- You are pregnant or suspect pregnancy
- You have an active pelvic infection
- You have cervical or uterine cancer (confirmed or suspected)
Benefits
- Quick & convenient: Done in 10–20 minutes; no hospital stay.
- Accurate diagnosis: Directly visualizes the uterine lining.
- Minimal downtime: Resume normal activities the same/next day.
- Therapeutic options: Can remove small polyps/tissue or take biopsies.
Risks and Complications
- Common (temporary):
- Mild cramping (like period pain)
- Light spotting/bleeding for 1–3 days
- Uncommon (<5%):
- Infection (antibiotics may be prescribed)
- Vasovagal reaction (dizziness/nausea)
- Rare (<1%):
- Uterine perforation
- Fluid overload (if fluid is used to expand the uterus)
Before the Procedure
- Timing: Schedule 1 week after your period (when bleeding is lightest).
- Medications:
- Take pain relief (e.g., ibuprofen/paracetamol) 1 hour before.
- Stop blood thinners (aspirin/warfarin) 3–7 days prior to procedure
- What to wear: Loose, comfortable clothing.
- Avoid: Vaginal creams, douches, or intercourse for 24 hours before.
During the Procedure
- Position: Lie on an exam table with legs in supports (like a cervical smear).
- Anaesthesia:
- Local anaesthetic gel/numbing spray applied to the cervix.
- Optional: Oral painkillers or mild sedation (discuss beforehand).
- Procedure steps:
- A speculum is inserted into the vagina.
- The hysteroscope (2–5mm wide) is gently passed through the cervix into the uterus.
- Saline fluid expands the uterus for clearer viewing (may cause cramping).
- Biopsies or minor treatments performed if needed.
- After: Rest in clinic for 15–30 minutes; then go home.
Recovery
- Immediately after:
- Cramping (use a heat pad/painkillers).
- Light bleeding (use sanitary pads; avoid tampons).
- At home:
- Rest: Take it easy for 24 hours.
- Avoid: Sex, swimming, baths, and heavy lifting for 48 hours.
- Hydration: Drink plenty of water.
- Return to work: Most resume work the next day.
Results
- Preliminary findings: Discussed immediately after the procedure.
- Biopsy results: Ready in 1–2 weeks (follow-up appointment needed).
Frequently Asked Questions
Q: Will it hurt?
A: Most feel mild cramping (like a period). Local numbing gel reduces discomfort.
Q: Can I drive home afterward?
A: Yes – if no sedation is used. With sedation, arrange a ride.
Q: Does hysteroscopy affect fertility?
A: No – it may improve fertility by treating issues (e.g., polyps).
Q: What if my bleeding continues beyond 3 days?
A: Light spotting for up to 1 week is normal. Contact your gynaecologist if bleeding is heavy (soaking 1 pad/hour) or foul-smelling.
Q: Is hysteroscopy the same as a cervical smear?
A: No – Cervical smears test cervical cells; hysteroscopy examines the uterine cavity.
eGynaecologist Advice:
- Out-patient hysteroscopy is safe and effective way to diagnose and treat some uterine issues. You may feel cramping similar to period pain and pressure or mild discomfort.
- You should seek consultation with your gynaecologist if you develop heavy bleeding (soaking >2 pads/hour), severe abdominal pain or fever or foul-smelling discharge.
- Pregnancy must be avoided for 1–2 months after the procedure (use contraception) to allow endometrium to heal, especially if treatment has been offered during the procedure.
