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what is a Hysteroscopy?

A hysteroscopy is a minimally invasive diagnostic and surgical procedure that allows a gynaecologist to examine the inside of the uterus (womb) using a thin, lighted telescope-like device called a hysteroscope. The hysteroscope is inserted through the vagina and cervix into the uterus, providing a clear view of the uterine cavity on a video monitor.

Hysteroscopy can be used for both diagnostic and therapeutic purposes. Diagnostic hysteroscopy is performed to investigate the cause of abnormal uterine bleeding, infertility, or recurrent miscarriages, or to check for uterine abnormalities such as polyps, fibroids, or adhesions. Operative hysteroscopy involves using specialised instruments passed through the hysteroscope to perform minor surgical procedures, such as removing polyps or fibroids, taking tissue samples (biopsy), or treating uterine adhesions.

How is a Hysteroscopy performed?

Hysteroscopy is usually performed as an outpatient procedure, either in a hospital or a specialised clinic. The procedure can be done under local anaesthesia, sedation, or general anaesthesia, depending on the complexity of the case and patient preference. Before the procedure, the patient may be given medication to help relax the cervix and reduce discomfort.

During the hysteroscopy, the patient lies on an examination table with their feet in stirrups. The gynaecologist gently inserts a speculum into the vagina to hold it open, and then guides the hysteroscope through the cervix into the uterus. A clear, sterile saline solution is then pumped through the hysteroscope to expand the uterine cavity and provide a clearer view. The gynaecologist examines the uterine lining, fallopian tube openings, and any visible abnormalities. If necessary, specialised instruments can be passed through the hysteroscope to perform minor surgical procedures. The entire procedure typically takes 15 to 45 minutes, depending on the complexity of the case.

What conditions can be diagnosed with a Hysteroscopy?

  • Uterine polyps
  • Submucosal fibroids
  • Uterine adhesions (Asherman's syndrome)
  • Uterine septum
  • Endometrial hyperplasia
  • Endometrial cancer
  • Congenital uterine anomalies
  • Retained products of conception after miscarriage or delivery
  • Intrauterine devices (IUDs) that have shifted out of place
  • Cause of abnormal uterine bleeding or postmenopausal bleeding
  • When should I have a Hysteroscopy?

    A hysteroscopy may be recommended if you experience symptoms or have conditions that suggest an abnormality within the uterus. Common indications for a hysteroscopy include:

    • Abnormal uterine bleeding, such as heavy or prolonged menstrual periods, bleeding between periods, or postmenopausal bleeding
    • Infertility or recurrent miscarriages
    • Suspected uterine abnormalities, such as polyps, fibroids, or adhesions, which may have been detected during a pelvic ultrasound or other imaging tests
    • Congenital uterine anomalies, such as a uterine septum
    • Retrieving displaced intrauterine devices (IUDs)

    Your healthcare provider will discuss the need for a hysteroscopy based on your individual symptoms, medical history, and any previous test results. In some cases, a hysteroscopy may be performed in conjunction with other procedures, such as endometrial ablation for heavy menstrual bleeding or myomectomy for uterine fibroids.

    what are the potential risks involved in a Hysteroscopy?

    Hysteroscopy is generally a safe and well-tolerated procedure, but like any surgical procedure, it carries some risks. Potential complications include:

    • Infection of the uterus or urinary tract
    • Injury to the uterus, cervix, or nearby organs, such as the bladder or bowel
    • Allergic reaction to the anaesthesia or other medications used during the procedure
    • Excessive bleeding during or after the procedure
    • Complications related to anaesthesia, such as nausea, vomiting, or respiratory problemsThese risks are relatively rare, and your healthcare provider will take precautions to minimise them. Be sure to discuss any concerns or pre-existing conditions with your provider before the procedure.

    who needs a Hysteroscopy?

    A hysteroscopy may be recommended for women experiencing various gynaecological issues, such as:

    • Abnormal uterine bleeding, particularly in cases where the cause has not been determined by other diagnostic methods
    • Infertility or recurrent miscarriages, to check for uterine abnormalities that may be impacting fertility
    • Suspected uterine growths, such as polyps or fibroids, which may be causing symptoms like heavy bleeding or pelvic pain
    • Congenital uterine anomalies, such as a uterine septum, which may impact fertility or pregnancy outcomes
    • Postmenopausal women with unexplained uterine bleeding, to rule out endometrial cancer or other pathology
    • Women with displaced intrauterine devices (IUDs) that need to be retrievedYour healthcare provider will determine if a hysteroscopy is appropriate for you based on your individual symptoms, medical history, and diagnostic needs.

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    Frequently Asked Questions

    You have a question? We have an answer.

    Is hysteroscopy painful?

    Most women experience minimal discomfort during a hysteroscopy, as the procedure is typically performed under some form of anaesthesia or sedation. You may feel some cramping or pressure during the procedure, similar to menstrual cramps. After the hysteroscopy, you may have some mild cramping or slight vaginal bleeding for a day or two. Over-the-counter pain relief medications, such as paracetamol or ibuprofen, can help alleviate any post-procedure discomfort.

    How long does it take to recover from a hysteroscopy?

    Recovery time after a hysteroscopy varies depending on the type of procedure performed and the type of anaesthesia used. Most women can return to normal activities within a day or two after a diagnostic hysteroscopy. If you had an operative hysteroscopy or received general anaesthesia, you may need a few additional days to recover. Your healthcare provider will give you specific instructions on post-procedure care and follow-up.

    Can I have a hysteroscopy during my period?

    It is generally recommended to schedule a hysteroscopy after your period has ended, as menstrual blood can obscure the view of the uterine cavity. However, in some cases, such as when investigating abnormal uterine bleeding, your healthcare provider may recommend performing the hysteroscopy during your period to better visualise the source of the bleeding. If you have any concerns about the timing of your procedure, discuss them with your provider.

    What is the cost of a Hysteroscopy in London?

    At Spital Clinic, a private Hysteroscopy with our expert Consultant gynaecologists costs £1780. We are open 7 days a week and can offer morning, day and evening appointments. If you are using private health insurance, please call the clinic to provide your authorisation number. To book, please click here.

    Will I need to take time off work after a hysteroscopy?

    An ultrasound scan, also known as sonography, is a medical imaging technique that uses high-frequency sound waves to create images of the inside of the body. It is a safe and painless procedure that does not use ionising radiation. Ultrasound scans are commonly used to monitor pregnancy, diagnose conditions, and guide medical procedures. The images are created in real-time, allowing healthcare professionals to view the structure and movement of internal organs and tissues.

    Can a hysteroscopy affect my fertility?

    A colposcopy typically takes about 15 to 20 minutes to perform. However, you should plan to be at the clinic for around an hour to allow time for preparation, the procedure itself, and any post-procedure discussions with your healthcare provider. If a biopsy is taken during the colposcopy, the procedure may take a few minutes longer, but the overall appointment time should not vary significantly.

    How often should I have a hysteroscopy?

    The frequency of hysteroscopy procedures depends on your individual medical needs and the reason for the initial procedure. In many cases, a single diagnostic or operative hysteroscopy is sufficient to identify and treat any uterine abnormalities. However, if you have a chronic condition, such as uterine adhesions or recurrent polyps, your healthcare provider may recommend periodic hysteroscopies to monitor and manage the condition. Additionally, if you are undergoing fertility treatment, your provider may suggest a hysteroscopy as part of your initial evaluation or to check the uterine cavity before an embryo transfer. Your healthcare provider will develop a personalised plan based on your specific circumstances and medical history.

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