Hysteroscopy is a minimally invasive gynaecological procedure that allows a doctor to examine the inside of the uterus using a thin, lighted instrument called a hysteroscope. It helps identify the possible causes of abnormal uterine bleeding, investigate certain fertility concerns, and diagnose or treat conditions affecting the uterine cavity. Depending on the patient's symptoms and medical history, hysteroscopy may be recommended as a diagnostic procedure or as part of a treatment plan.
Understanding what happens during a hysteroscopy, why it may be needed, and how recovery works can help women feel more confident before the procedure. A gynaecologist will explain the process, discuss potential risks, and determine whether hysteroscopy is appropriate for the individual patient's needs.
1. When Is Hysteroscopy Recommended
Hysteroscopy may be recommended when a woman experiences abnormal uterine bleeding, including unusually heavy periods, irregular bleeding, or bleeding after menopause. It allows the doctor to examine the uterine lining and investigate abnormalities that may not be fully explained by other tests. The procedure may also help identify the cause of certain menstrual problems.
One common reason for hysteroscopy is the investigation of uterine polyps and submucosal fibroids. Polyps are growths that develop from the uterine lining, while submucosal fibroids grow into the uterine cavity. Depending on their size and location, these conditions may contribute to heavy menstrual bleeding or reproductive difficulties. Hysteroscopy can help the doctor examine these growths and, when appropriate, remove them during the same procedure.
Hysteroscopy may also be used to investigate suspected adhesions inside the uterus, sometimes called intrauterine adhesions. These scar tissues can develop following certain uterine procedures or infections and may affect menstrual patterns or fertility. In selected cases, hysteroscopy can help assess the uterine cavity when a woman experiences difficulty becoming pregnant or has recurrent pregnancy loss.
During the consultation, the gynaecologist may review symptoms, medical history, and ultrasound findings before recommending the procedure. Not every patient with abnormal bleeding or fertility concerns requires hysteroscopy. The decision depends on the suspected condition, previous test results, and the potential benefits of further investigation.
2. What Happens During Hysteroscopy and How Is Recovery
Before the procedure, the doctor explains the preparation required and whether any medication or additional testing is necessary. Hysteroscopy is often scheduled after menstruation, when appropriate, because the uterine lining may be easier to examine. Patients should inform their doctor if pregnancy is possible, if they have an infection, or if they take medicines that could affect bleeding.
During hysteroscopy, the doctor gently passes a thin hysteroscope through the vagina and cervix into the uterus. Fluid is usually introduced to help expand the uterine cavity and provide a clearer view. The doctor examines the uterine lining and checks for abnormalities. If necessary and planned, small instruments may be passed through the hysteroscope to take a tissue sample or treat certain conditions, such as removing a polyp.
Some diagnostic procedures can be performed in an outpatient setting without general anaesthesia, while operative hysteroscopy may require local, regional, or general anaesthesia depending on the procedure and the patient's circumstances. The duration varies according to the complexity of the examination or treatment.
After hysteroscopy, mild cramping and light vaginal bleeding or spotting may occur for a few days. Many women return to normal activities relatively quickly after a simple diagnostic procedure, while recovery may take longer following operative treatment. Patients should follow their doctor's advice about pain relief, hygiene, sexual activity, and returning to work.
Although complications are uncommon, possible risks include infection, bleeding, injury to the uterus, or reactions related to anaesthesia. Seek medical attention if you experience severe abdominal pain, heavy bleeding, fever, or foul-smelling vaginal discharge after the procedure.
Understanding the reason for Hysteroscopy and following appropriate medical guidance can help women make informed decisions about their reproductive health. Dr. Preeti Tandon at Fakeeh University Hospital provides expert healthcare regarding this, supporting women with professional gynaecological guidance and personalised care.