Hysteroscopy

Hysteroscopy is an endoscopic technique for examining the inside of uterus. A long, fine camera (hysteroscope) is inserted through the cervical opening in the vaginal canal. This camera projects video images of the uterine cavity on a high-resolution screen. Endoscopic procedure is a form of minimally invasive surgery. No incisions are needed on the abdominal skin.

Hysteroscopy is performed to make a diagnosis (diagnostic hysteroscopy) or to carry out a therapeutic procedure (operative hysteroscopy).

Diagnostic hysteroscopy

Hysteroscopy is useful for viewing inside the uterus and cervix to identify cause of heavy menstrual periods, irregular bleeding and abnormal bleeding after menopause (post-menopausal bleeding). It is also used to evaluate any suspected uterine abnormalities that cause fertility issues or difficulty in falling pregnant.

A biopsy can be taken at the lining of uterus for pathology. Hysteroscopy combining with biopsy is a highly accurate test to rule out cancer inside the uterus. It can also confirm the diagnosis of polyps and fibroids on the lining of uterine wall.

Hysteroscopy allows the surgeon to see clearly inside the uterus. However, it does not produce image of the structures outside the uterine cavity, such as ovaries or other pelvic organs. If evaluation of these organs is needed, our specialist may arrange other tests such as a pelvic ultrasound scan or a laparoscopy, which can be done either in the same surgery or as a separate test.

Hysteroscopy is a single-day procedure. A diagnostic hysteroscopy usually lasts for less than 30 minutes. Patients can go home on the same day. Recovery takes 1-2 days.

It can be done in an out-patient clinic, although many women may prefer to have it a proper operation theatre after putting under sleep (general anaesthesia). The choice is based on the individual tolerance to the procedure, previous normal deliveries or cervical surgery, the likelihood of presence of pathology, and if any operative procedures need to be done at the same time.

What to expect after a hysteroscopy?

After a hysteroscopy, you will stay in the recovery rooms for a couple of hours until you have recovered well from general anaesthesia, if it is used. You will have some bleeding from the vagina like a menstrual period. The bleeding will be getting less in the following days. It is common to experience some dull pain over the lower abdomen, similar to a menstrual cramp. The pain will usually resolve after some rest in the evening following the surgery. Simple analgesics such as Panadol or Napropen can help. Most women can resume normal activities in 1-2 days. You will arrange a complimentary follow-up visit at our clinic in around 2 weeks’ time. Our doctor will provide more instructions on post-operative care before you go home.

Operative hysteroscopy

We also use hysteroscopy to carry out surgical procedures to correct many of the gynaecological problems, such as:

• removing a fibroids inside the uterus (hysteroscopic myomectomy)
• removing a polyps on lining of uterus (hysteroscopic polypectomy)
• treatment of heavy menstrual period (hysteroscopic resection of endometrium)

Know more about heavy menstrual period and our specialized treatment programme

• permanent contraception (hysteroscopic tubal occlusion – Essure)
• removing adhesions and septum inside uterus
• fertility treatment – releasing blockage of fallopian tubes (hysteroscopic tubal cannulation)