A hysteroscopy enables your doctor to inspect, diagnose and possibly treat problems affecting the inside of your uterus. It may be used as an alternative to hysterectomy (removal of your uterus) or a dilatation and curettage (D&C). As such, it’s less invasive, less painful and it has a faster recovery time than both the alternatives.
97% of women would recommend this procedure to their friends although 17% of women experience significant discomfort when it’s performed in their doctor’s office without any anaesthetic.
For most women, any pain settles immediately afterwards. Feeling anxious before the procedure is associated with greater likelihood of pain during the procedure.
If you’re concerned about possible discomfort, talk to your doctor about your options for pain relief, anaesthesia or sedation.
Hysteroscopy, which may be combined with other procedures, is a relatively low risk procedure. In 3% of women, the procedure is unsuccessful. This can be because your doctor has difficulty getting the instrument through your cervix, because your uterus is unusually positioned, or because your doctor has difficulty seeing inside your uterus due to blood or an obstruction.
The overall risk of complications is less than 1%. The risks increase depending on the procedures that are performed during the hysteroscopy. The main risks and complications are:
Damage to the uterus
This is the most common complication, and may require treatment with antibiotics in hospital or, in rare cases, another operation to repair it.
Complications from fluid or gas used to expand the uterus
The fluid used to expand your uterus occasionally causes excess fluid to build up in the body. If gas is used to expand your uterus, it can result in shoulder pain which usually resolves within 15 minutes.
Excessive bleeding during or after surgery
This can be treated with medication or another procedure; very rarely it may be necessary to remove your uterus (hysterectomy).
Damage to the cervix or bladder
This is rare and can usually be easily repaired.
Infection of the uterus
This can cause smelly vaginal discharge, fever and heavy bleeding. It’s usually treated with a short course of antibiotics. Avoiding tampons and using sanitary pads for any post-procedure bleeding can help to reduce your risk of infection.
Some women who’ve had a hysteroscopy without an anaesthetic or with just local anaesthetic, experience feelings of faintness afterwards. It’s caused by a temporary drop in blood pressure due to irritation of the vagus nerve during the procedure. Recovery is usually quite quick.
If complications occur, your doctor may need to halt the procedure and a different procedure may be required.
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