• Reference Number: HEY-732/2016
• Departments: Gynaecology
• Last Updated: 1 January 2016

Introduction

This leaflet has been produced to give you general information about your procedure.  Most of your questions should be answered by this leaflet.  It is not intended to replace the discussion between you and your doctor, but may act as a starting point for discussion.   If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team caring for you.

What is a Hysteroscopy?

You have probably been troubled by a number of symptoms and following a discussion with your doctor, you have been advised that you will need to undergo a hysteroscopy.

This is a procedure that allows a doctor to look directly into your womb. A thin telescope called a hysteroscope is passed gently through the cervix (the neck of your womb) into the womb itself. A television camera can be attached to the hysteroscope, so that the doctor will be able to see inside your womb. At this stage, any disease or abnormality can be seen and a biopsy (a sample of tissue) may be taken if required.

What are the benefits of having a Hysteroscopy?

A hysteroscopy is performed for several reasons, these include:

• Heavy or irregular bleeding that has not improved with tablets prescribed to you by your doctor
• Bleeding in-between your periods
• Bleeding more than 1 year after menopause
• Irregular bleeding whilst you have been taking Hormone Replacement Therapy (HRT)
• If you are thinking about having an operation to make your periods less heavy (Endometrial ablation or microwave ablation).

Can there be any complications or risks

The risks associated with this procedure are minimal, however the risks that may occur include:

• The risk of a small hole being made in the womb and subsequent infection
• The neck of the womb may be too tight to allow the passage of the telescope.  In this case, a hysteroscopy under general anaesthesia may be needed, which will be booked for another date
• Some women may experience excessive discomfort during the procedure and in this case the procedure would be abandoned
• Bleeding
• Damage to the uterus
• Damage to bowel, bladder or major blood vessels
• Failure to gain entry to uterine cavity and the ability to complete the procedure
• Infertility

The overall risk of serious complications from a diagnostic hysteroscopy is approximately 2 in 1000 women.

How Do I Prepare for a Hystreroscopy?

 Please read this information leaflet and share it with your partner and family (if you wish) so that they can be of help and support.  There may be information they need to know, especially if they are taking care of you following this procedure.

To alleviate any discomfort during and after the procedure, it may helpful if you take some pain relief 1-2 hours before your appointment. Pain relief such as Ibuprofen is preferable.

What will Happen?

When you come to the department, the doctor will explain the procedure to you. At this stage, if there are any questions that you would like to ask about the procedure, please do so.

You need to inform the doctor if you have any allergies or bad reactions to drugs or other tests in the past. They also would like to know about any previous surgery or operations you have undergone.

You will then be asked to remove all clothing from your waist down. A nurse will be with you throughout the whole of the procedure and you will be made to feel as comfortable as possible on either an examination couch or chair.  You will then be asked to rest your legs on two leg supports.

An instrument, which is the same sort of instrument that is used when you have a smear test, is then inserted into your vagina.  This is to allow the doctor to see the neck of your womb. Sometimes local anaesthetic is injected into the neck of the womb. The hysteroscope is then gently placed close to the outer opening of the neck of your womb. Fluid is passed into your womb as the hysteroscope as is slowly passed through the neck of your womb.

If you wish you are able to watch the process on the television screen. If you do not wish to see the screen please let the doctor or nurse know.  At this point the doctor may wish to take some images, however you will be asked to give your consent before these are taken.

During the procedure you may experience cramps within the lower part of your tummy, this can be likened to period pain. These will settle after the procedure has finished.

A biopsy of the lining of the womb may also be taken at the end of the procedure. If you find this part of the procedure uncomfortable, please inform the doctor or nurse. Any findings identified during the procedure can be explained at the time, please do not hesitate to ask the doctor or nurse for any information or clarification.

Some women do feel faint after the procedure, if this happens you will be asked to rest on a recliner chair.  You may also experience a dull ache which can last for a few hours after the procedure.  Taking pain relief will usually help.

The whole procedure is likely to take about 10 minutes.  It is only natural for you to worry about the procedure and most women are surprised that it is completed this quickly.

There may be occasions where we are unable to pass the hysteroscope into your womb and this will mean that the procedure will have to be abandoned. If this is something that happens during your procedure, the doctor will explain fully what further options are available to you.

What happens afterwards?

After the procedure you will be asked to rest in a nearby waiting area where you will be offered a drink. You may then eat and drink normally.

It is a good idea to bring your partner or friend to accompany you home to provide you with support. However you can drive yourself home after the procedure as you have not been administered any medication.

It is likely that you will experience minimal vaginal bleeding for a day or so after the procedure.  During this time we would advise that you do not use tampons, engage in sexual intercourse or go swimming until any bleeding has stopped. If your bleeding becomes heavier (more than a normal period) or you have a discharge which has an offensive odour then you should contact your GP for advice.

When will I know my results?

Immediately after the examination the doctor will explain the findings to you.  If a biopsy is taken or you have had a polyp removed at the time of the procedure, it will be several weeks before the results are available. You may have your results sent to you by letter or you may receive a follow up appointment.

Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact the Gynaecology Outpatient Department on tel no (01482) 607829

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

• you must be able to give your consent
• you must be given enough information to enable you to make a decision
• you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.