Hysteroscopy — A Complete Guide
Current Guidance Update
First-Line Assessment
Outpatient hysteroscopy should be offered as the first-line investigation for women with abnormal uterine bleeding or suspected intrauterine pathology.
Office Hysteroscopy
Office hysteroscopy with appropriate pain management is a safe, effective, and well-tolerated procedure, providing high levels of patient satisfaction.
Superior Diagnostic Accuracy
Hysteroscopy is more accurate than standard 2D ultrasound for detecting intrauterine abnormalities such as polyps, adhesions, and submucosal fibroids.
Early Diagnosis
Timely hysteroscopic evaluation enables direct visualization of the uterine cavity, allowing accurate diagnosis and immediate treatment planning when necessary.
Introduction
Hysteroscopy: Procedure, Uses & Recovery
How Hysteroscopy Works
A thin telescopic camera is passed through the cervical canal into the uterine cavity, which is gently expanded with saline or CO₂ for clear visualization. The procedure can be performed in an outpatient clinic under local anaesthesia or in an operating theatre under general anaesthesia depending on complexity.
When It Is Recommended
- Abnormal uterine bleeding
- Endometrial thickening on ultrasound
- Recurrent miscarriage investigation
- Infertility assessment before IVF
- Abnormal HSG findings
- Suspected polyps, fibroids, or intrauterine adhesions
Operative Hysteroscopy
- Polypectomy
- Submucosal fibroid resection
- Adhesiolysis for Asherman's syndrome
- Septum resection
- Endometrial ablation
- IUCD retrieval
What to Expect
Outpatient diagnostic hysteroscopy usually lasts 5–10 minutes and involves local anaesthetic gel with mild-to-moderate cramping. Most women return to normal activities the same day, while operative procedures may require 1–2 days of recovery.
Aftercare Instructions
- Light spotting for 1–2 days is normal.
- Avoid intercourse, tampons, and swimming for 5–7 days.
- Paracetamol or ibuprofen may be used for cramping.
- Seek medical advice if heavy bleeding, fever, or severe pelvic pain develops.
Frequently Asked Questions
Does hysteroscopy improve fertility?
Correction of uterine cavity abnormalities consistently improves implantation rates and fertility outcomes.
How long does recovery take?
Diagnostic hysteroscopy allows same-day recovery; operative hysteroscopy usually requires 1–2 days off work.
Conclusion
Hysteroscopy is a safe, well-tolerated, highly informative procedure that should be the first-line investigation for abnormal uterine bleeding and suspected intrauterine pathology.
Sources & References
This article draws on guidance current at the time of writing from the following bodies and publications:
- NICE (2023)
- RCOG (2020, updated 2023)
- ACOG (2021)
General reference bodies for women's health guidance:
RCOG
rcog.org.ukACOG
acog.orgFIGO
figo.orgWHO
who.intNICE
nice.org.uk⚠ IMPORTANT DISCLAIMER
This article is provided for general knowledge and reference purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. No medication, treatment, or change to your healthcare should be undertaken based on this content without first consulting a qualified doctor. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.
