Patient
Information
Outpatient hysteroscopy
diagnosis and treatment
What is a hysteroscopy and why do I need one?
Hysteroscopy is the examination of the inside of the womb (uterus) using a fine telescope.
It is mostly done as an outpatient procedure, but can be offered under general anaesthetic
if you are unable to tolerate the examination in the outpatient setting.
It allows certain abnormalities inside the womb to be seen. Not all women with the following
problems need to undergo the procedure, but it can provide useful information if you have:
x
Abnormal uterine bleeding (that means bleeding between periods), bleeding after
the menopause or excessive menstrual bleeding.
x
Abnormal thickening of the lining of the womb (polyp) or lump protruding into the
uterine cavity from the wall of the womb (fibroid).
x
Or before treatment such as endometrial ablation, to determine size and shape of
the uterine cavity.
Where will I have the hysteroscopy?
The hysteroscopy will be performed in the Gynaecology Outpatients Department, which is
situated on Level 1 of the Maternity & Gynaecology Block, Royal Derby Hospital. The best
place to park is in Car Park 6, and then enter the Maternity & Gynaecology block by
Entrance 20 or 21. The Gynaecology Outpatients Department is opposite the League of
Friends shop.
We recommend that you have something to eat before attending for your appointment.
What will happen when I go for the investigation?
The doctor will ask you questions about your symptoms, including the dates of any recent
vaginal bleeding, and will explain the procedure. You will then be asked to sign a consent
form, if you haven’t already done so. You will be asked to undress sufficiently for the
examination. You are then helped onto a special examination couch by a healthcare
assistant (HCA).
A fine telescope, the hysteroscope, is passed through the cervix and into the womb. You
will feel damp during the procedure as fluid is used to open the way into the womb.
Sometimes, a speculum (as used for smear tests) will need to be inserted into the vagina
to identify the cervix. A camera attached to the hysteroscope allows the view inside the
womb to be seen on a colour TV screen. Once the telescope is inside the womb, the
examination only takes 1 - 2 minutes, unless you are having an additional procedure like
the removal of a polyp (which will be discussed with you by the doctor beforehand).
www.derbyhospitals.nhs.uk
Very occasionally, a local anaesthetic is injected into the cervix (especially if it is tightly
closed). This is to enable cervical dilatation and to make the procedure more comfortable
for you.
After the hysteroscope is removed, a small sample of the lining of the womb may be taken
using a fine tube, which is passed through the cervix (a pipelle biopsy).
If indicated and agreed by you and the doctor previously, a Mirena coil may be inserted to
treat heavy periods.
How long does it take?
The initial camera test (diagnostic hysteroscopy) only takes a few minutes.
If you are having a treatment like polyp removal, the procedure can take 15 - 30 minutes,
depending on the size and location of the polyp, and on the technique used by the
consultant.
If you are attending the One Stop Clinic, the visit may take up to 3 hours as you may need
an ultrasound scan (in the Radiology department), followed by a consultation with the
doctor, then the actual procedure/treatment and finally a recovery period.
Will it be painful?
Most women are comfortable during the procedure as the telescope used is very fine
(thinner than a pencil). About 8 out of 10 women do not feel the need for any pain relief for
this procedure. Some women do find the procedure uncomfortable and will be offered
Entonox (gas and air mixture) which helps with the pain and also helps you to relax.
Some women experience period-type pain, which usually disappears rapidly, but may last
for up to a day afterwards, especially if the procedure has included for example, the
removal of a polyp.
We strongly recommend you take some painkillers, such as Paracetamol and Ibuprofen
(regular medication taken for painful periods) 1 - 2 hours before coming to the clinic. This
would especially help if you need any additional treatment at the same time (such as when
a polyp is suspected on your ultrasound scan).
If you are unable to cope with the discomfort, you can ask the doctor to stop and choose to
have the procedure under a general anaesthetic instead. If this is the case, you will be put
onto the waiting list for a later date.
You will not be given any drugs that will affect your ability to drive, although we recommend
you get someone to drive you back home, especially if you have had an additional
procedure.
Are there any risks?
There are risks involved with any procedure. Although this procedure is extremely safe,
rarely, complications can occur.
There is a small risk of infection. If you find you have an increase in temperature, pain,
offensive vaginal discharge or heavy bleeding after you have had the procedure performed,
you should contact your GP or the hysteroscopy clinic.
There is also a very small risk of the instrument perforating the wall of the womb (making a
tiny hole). This usually heals spontaneously, however treatment for this complication may
include antibiotics and very rarely, an admission to the ward for observation.
Are there any alternative treatment options?
Your consultant has recommended this procedure as being the best option.
However, the alternative to this procedure being carried out as an outpatient is to have it
done as a day case procedure under a general anaesthetic.
There is also the option of not receiving any treatment at all. The consequence of not
receiving any treatment at all is that we will not be able to find out what the problem might
be. If you would like more information, please speak to your consultant or one of the nurses
caring for you.
What happens after the procedure when I go home?
You will be able to go home after the procedure, but you may need to rest for a while first
(about 15 - 30 minutes) in the recovery area.
You may experience light to moderate bleeding soon after the procedure and for the next
few days. It is advisable to bring a sanitary pad with you (not a tampon).
You can have a shower or bath as you would normally.
You may resume intercourse once you feel comfortable.
When do I get the results of my tests?
The doctor will explain the findings to you immediately and will discuss the treatment you
may need.
If a sample (biopsy) has been taken at the time, we usually write to you with the result. This
takes a few weeks. Occasionally, if necessary, the doctor may arrange another
appointment for you to discuss the results.
IMPORTANT
If you think you could be pregnant or your normal period is due on the day of your
investigation, please ring the numbers provided below.
If you have experienced any post-menopausal bleeding, we will want you to attend
regardless of ongoing bleeding.
If you have any queries, or require further information,
please telephone 01332 789217 to speak to a nurse.
To change an appointment, please telephone 01332 785466.
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