🔬 Hysteroscopy: Everything You Need to Know

Hysteroscopy is considered one of the most important modern medical techniques that has revolutionized the diagnosis and treatment of uterine problems. It allows the doctor to view the uterine cavity directly without the need for an abdominal incision.

What is Hysteroscopy?

A hysteroscope is a long, thin tube containing a light source and a camera at its end. It is passed through the vaginal opening without any surgical incisions, and transmits an image of the uterus and cervix to a monitor in front of the doctor.

Types of Hysteroscopy

There are two main types of hysteroscopy:

Diagnostic Hysteroscopy

Used to discover the cause of a problem only, such as determining the reason behind abnormal bleeding or delayed pregnancy, or confirming imaging results. It can be performed in the doctor's clinic.

Operative Hysteroscopy

Used to treat a problem after it has been discovered. Precise surgical instruments are inserted through the hysteroscope to remove tumors, polyps, or to treat adhesions.

When Do You Need Hysteroscopy?

A doctor may request a hysteroscopy in the following cases:

• Severe bleeding during or between periods.
• Postmenopausal bleeding.
• Delayed pregnancy or recurrent miscarriages.
• Removing uterine fibroids and polyps.
• Treating uterine adhesions.
• Removing a uterine septum (a congenital defect).
• Displacement of an IUD.
• Taking a biopsy from the uterine lining.

What is the Best Time for a Hysteroscopy?

During the first week after the end of the menstrual period - this timing provides the clearest view of the inside of the uterus.

How is Hysteroscopy Performed? (Step by Step)

1. Preparation: Lying on a specialized bed with legs secured.
2. Sterilization: Disinfecting the vagina and cervix.
3. Dilation: Dilating the cervix to allow the hysteroscope to enter.
4. Insertion: Passing the hysteroscope through the vagina into the uterus.
5. Expansion: Pumping liquid or gas to expand the uterus and clear the view.
6. Examination/Treatment: Viewing the uterus on the monitor and performing treatment if necessary.

Is Hysteroscopy Painful?

The sensation varies from woman to woman. Some women feel no pain at all, while others may experience mild discomfort.

Options for Pain Relief:

• Taking a painkiller (e.g., Paracetamol) before the procedure.
• Local anesthesia.
• General anesthesia (for operative hysteroscopy).

Benefits of Hysteroscopy

Risks and Complications

Hysteroscopy is very safe - complications occur in less than 1% of cases.

• Anesthesia risks (rare).
• Infection.
• Bleeding.
• Injury to the cervix or uterus (very rare).
• Allergic reaction to the materials used.

How Do You Prepare for Hysteroscopy?

A Week Before:

• Perform required blood tests.
• Take a pregnancy test to confirm you are not pregnant.
• Inform the doctor about any medications you are taking.
• Stop blood thinners as directed by your doctor.

Day of the Procedure:

• Fasting: 6-8 hours prior if under general anesthesia (no fasting needed for local anesthesia).
• Wear comfortable clothing that is easy to remove.
• Bring a companion to help you return home (especially with general anesthesia).
• Take a mild painkiller before the procedure as directed by the doctor.

What Happens After Hysteroscopy?

Normal Post-Procedure Symptoms:

• Mild cramps similar to menstrual pain (for a day or two).
• Light bleeding or spotting.
• Shoulder pain if gas was used (disappears quickly).

Tips for a Quick Recovery:

• Rest: Take a day or two off after an operative hysteroscopy.
• Painkillers: Paracetamol or Ibuprofen as needed.
• Bathing: Showers are preferred over baths (soaking) for a week.
• Avoid Sexual Intercourse: For at least a week or until bleeding stops.
• Avoid Tampons: Use sanitary pads only.

Cost of Hysteroscopy

The cost varies based on several factors:

Prof. Dr. Mohamed Abdel Fattah El-Senity

Consultant Obstetrics and Gynecology

Expert in Hysteroscopy and Laparoscopy

Ain Shams University Hospitals

+20 Years of Experience

Frequently Asked Questions About Hysteroscopy