Before a hysteroscopy you may be referred for a number of tests to make sure it is safe for you to have surgery.
These tests may include blood tests, a pregnancy test and a cervical smear test to check for infection or any abnormalities with your cervix.
GnRH agonists
If you are having a hysteroscopy to remove abnormal tissue growth, such as fibroids or polyps, you may be given a type of medication called a GnRH agonist to take for a while before having surgery.
This helps shrink abnormal tissue growth, which can increase the chances of successful surgery and reduce the risk of excessive bleeding.
GnRH can cause menopausal-like side effects such as hot flushes and excessive sweating. These should pass when you stop taking the medication.
Choice of anaesthetic
It is possible to have a hysteroscopy with or without a local anaesthetic. This will usually be carried out in the outpatients department of a hospital.
A hysteroscopy should not hurt, as it is a similar sensation to having a smear test. However, if you are not having any anaesthetic, you may wish to take a painkiller, such as ibuprofen, beforehand.
The procedure can also be carried out under general anaesthetic (when you are asleep) as a day case operation. This may be recommended if your surgeon expects to do extensive treatment at the same time, or if you request it.
The procedure
The surgeon will gently put an instrument, called a speculum, into your vagina. This holds the walls of the vagina open enabling easy access to your womb.
Next, the vagina and cervix are cleaned with an antiseptic solution. The surgeon will then insert the hysteroscope through your cervix into your womb.
As the womb is small, gas or fluid may be pumped inside to make it larger. This helps the surgeon see the lining of the womb, and any abnormalities, more clearly. The camera at the end of the hysteroscope sends pictures from the inside of your womb to a video screen.
Surgical instruments similar to a hysteroscope can also be passed into your womb, if required, where they can be used to cut or burn away abnormal tissue growth. Tissue can be removed using a number of techniques such as lasers, electrical current and specially designed blades.
A sample of tissue can also be removed for further testing (biopsy) if required.
A hysteroscopy usually takes between 10 and 30 minutes depending on what needs to be done.
