Hysteroscopy is used to examine the cavity or the lining of the uterus (womb). It can be used for diagnostic examination, or treatment of blocked fallopian tubes, endometriosis or adhesions. Sometimes, examination and treatment occur at the same time. Hysteroscopy is applied to the treatment of uterine fibroids, scar tissue, polyps and congenital disorders such as a uterine partition.

This procedure occurs under either local or general anaesthesia. While diagnostic hysteroscopy can take place in the offices of your doctor, treatment is usually carried out in an operating theatre. The hysteroscope, an illuminated tube, is introduced into the uterus via the cervix. The procedure is normally carried out at the beginning of a woman’s menstrual cycle. Before the hysteroscope is introduced, the cervical canal is widened (dilated).

In addition to the hysteroscope, carbon dioxide or a fluid is also introduced into the uterus in order to enlarge the cavity and to remove blood and mucus that might be present.

During surgical (as opposed to diagnostic) hysteroscopy, a larger hysteroscope is employed so that surgical instruments can be introduced into the uterine cavity via the hysteroscope. After the operation, a Foley catheter (flexible tube) or spiral can be placed in the uterus to ensure that the walls do not stick together or form scar tissue. The catheter or spiral is removed after a few days.

This procedure is not painful, but the following side effects can occur:

• Abdominal pain after the operations, sensitivity and bruising to the abdomen.
• Nausea or headaches as a result of the anaesthesia.
• Cramps and vaginal secretions can occur.

• Damage to internal organs (intestine, bladder, urinary tracts), which require emergency surgical intervention (unusual side effect, this occurs in 2-4 operations out of 1000).
• Lung oedema (fluid in the lungs) as a result of the fluid that is injected into the uterus (occurs rarely).
• Perforation of the uterus (the opening normally repairs itself naturally).
• Heavy blood loss and high temperature are signs that a doctor must be consulted.