Hysteroscopy
Hysteroscopy is the most accurate examination of the inside of the uterus to assess the shape of the uterus, the condition of the mucosa and the fallopian tubes. The procedure is performed by inserting a thin speculum with a camera through the cervical canal, which makes it possible to detect changes that are not visible on ultrasound. Hysteroscopy makes it possible not only to diagnose, but also to remove polyps, myomas or adhesions in a single procedure. The examination is performed under general anaesthesia for the comfort of the patient. It is particularly useful in women with menstrual disorders or problems getting pregnant. Find out about the preparation for the procedure and what you can expect.
Highlights
- Hysteroscopy can detect abnormalities not visible on ultrasound and is the most accurate examination to assess the anatomy of the uterine cavity.
- The examination is performed under general anaesthesia, takes 10-15 minutes and consists of an assessment of the cervical canal, the uterine cavity and the fallopian tube orifices.
- Contraindications to hysteroscopy are pregnancy, the onset of menstruation and ongoing inflammation in the body.
What is a hysteroscopy?
Hysteroscopy is a diagnostic and therapeutic procedure used to assess the shape of the uterine cavity, the condition of the endometrium and the uterine orifices of the fallopian tubes. During the examination with a hysteroscope, the doctor performs a detailed visualisation of the inside of the uterus and can thus see even small pathological changes within the mucosa, such as endometrial polyps, submucosal myomas and intrauterine adhesions.
How to prepare for a hysteroscopy?
Hysteroscopy is most often performed under general intravenous anaesthesia. For this reason, the patient should report for the procedure on an empty stomach.
Hysteroscopic examinations are performed in the first phase of the menstrual cycle (before ovulation). Slight spotting occurring towards the end of periods is not a contraindication to the procedure.
The following investigations should be done before the hysteroscopy:
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VDRL,
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Anti-HCV-Ab,
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Anti-HBC IgM,
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HBs Ag
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Anti-HIV-1,2.
Occasionally, it is necessary to perform additional tests, for example an ECG and a chest X-ray in women who are over 40 years of age. Preparation for hysteroscopy may also include the use of hormonal medication, which affects the thickness of the endometrium.
Patients who have a history of allergy symptoms to any medication should inform their doctor before qualifying for the procedure.
Contraindications to hysteroscopic examination
Diagnostic hysteroscopy cannot be performed during pregnancy. The onset of menstrual bleeding is also not an appropriate time to perform the examination. An important contraindication for assessment of the inside of the uterus is ongoing inflammation.
Does a hysteroscopy hurt?
Hysteroscopy is usually a painless examination for most patients, but for the comfort of the woman the examination is performed under general anaesthesia.
Tests required for anaesthesia:
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APTT
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Sodium
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Potassium
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When is it worth having a hysteroscopy?
Hysteroscopic examination is recommended for women who:
Indications for hysteroscopy are also:
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pathological changes in the endometrium previously detected by ultrasound,
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anatomical defects of the uterus,
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suspected intrauterine adhesions.
Hysteroscopy and endometrial polyps
Endometrial polyps can cause difficulties in getting pregnant. In patients trying for pregnancy, they should be removed. The excised lesions will then be examined histopathologically (statistically 1% lesions of this type are malignant).
Information on uterine polyps can be found on many medical websites, but the most reliable information will be provided by your doctor during your consultation.
Operative hysteroscopy
Operative hysteroscopy, also referred to as operative hysteroscopy, helps in the diagnosis of excessively heavy periods, endometrial proliferations, anatomical abnormalities of the uterus and the aforementioned pathological changes (polyps, myomas and intrauterine adhesions).
The surgical hysteroscopy procedure is performed transvaginally. The continuity of the abdominal lining is not interrupted.
Recommendations and possible discomfort after hysteroscopy
Recommendations
After a surgical hysteroscopy, a woman can go home after only two hours (unless there is a need for daily observation of the patient) and the healing process is much shorter than in the case of a classic transabdominal operation. No lifting or strenuous exercise is allowed during the recovery period.
Price of hysteroscopy
In Invimed clinics, hysteroscopy is performed by experienced medical teams consisting of a gynaecologist, anaesthetist, midwives and nurses. Prices for diagnostic hysteroscopy - depending on the clinic - start from £1,100 and for surgical hysteroscopy from £1,600. Current prices can be found in the price list of the chosen clinic. Hysteroscopy is always performed with anaesthesia (payable separately).
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- Bręborowicz, G. H. (ed.). (2020). Obstetrics and gynaecology. Volume 1-2 (3rd ed.). Warsaw: PZWL Wydawnictwo Lekarskie. ISBN: 9788320061464.
- Zimmer, M., Pomorski, M., Kamiński, P., Doniec, J., Huras, H., Sieroszewski, P., Sikora, J., Stojko, R., Ludwin, A., Radwan, M., & Fuchs, T. (2019). Rekomendacje Polskiego Towarzystwa Ginekologów i Położników dotyczące zastosowania histeroskopii w ginekologii. Ginekologia i Perinatologia Praktyczna, 4(3), 133-142. Pobrano z: https://www.ptgin.pl/sites/scm/files/2021-09/09.2019%20Rekomendacja%20Polskiego%20Towarzystwa%20Ginekolog%C3%B3w%20i%20Po%C5%82o%C5%BCnik%C3%B3w%20dotycz%C4%85ce%20zastosowania%20histeroskopii%20w%20ginekologii.pdf
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Zapytaj o terminFrequently asked questions - FAQ
Hysteroscopy does not adversely affect fertility; on the contrary, it removes causes of infertility such as polyps or adhesions. After the procedure, the chances of getting pregnant usually increase.
Doctors recommend abstaining from intercourse for 1-2 weeks after the procedure to avoid infection and allow for proper healing. The exact time will be determined by your doctor during your check-up.
Hysteroscopy assesses only the inside of the uterus, while laparoscopy examines the fallopian tubes, ovaries and abdominal space. These are complementary examinations and not competing diagnostic methods.
Hysteroscopy can be repeated without limitation when there is a medical need. The procedure does not damage the uterus or affect its ability to regenerate.
Yes, hysteroscopy detects small polyps, subtle adhesions and early mucosal changes that ultrasound may not visualise. Therefore, it is the „gold standard” for assessing the inside of the uterus.
The medical information presented should be considered as general guidelines and does not replace the individual judgement of the doctor regarding the medical management of each patient. The doctor, after a thorough examination of the patient's condition, determines the extent and frequency of diagnostic tests and/or therapeutic procedures, taking into account specific medical indications. All medical decisions are made in full consultation with the patient.
Author of the article
Invimed editorial team - we serve patients by solving their fertility problems. We use world medical knowledge, state-of-the-art technology and treatment methods. We are here to make dreams of parenthood come true. The smiles on the faces of happy parents give meaning to our work.
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