The most widely reported complications of a hysteroscopy – accidental damage, infection and excessive bleeding – are explained below.
Accidental damage
Accidental damage to the womb or cervix is the most common complication of a hysteroscopy, occurring in around 1 in 135 cases.
A section of the cervix can sometimes become torn, or the lining of the womb can sometimes be perforated (a hole is made in it).
Minor damage that does not cause excessive bleeding is not usually a cause for concern. But if a more significant injury is suspected, you may require a procedure known as a diagnostic laparoscopy. This is where a tiny camera is passed into your womb through an incision in your abdomen, to assess the damage.
In rare cases (around 1 in 700 cases) further surgery is then required to repair the damage.
Infection
In around 1 in 250 cases the womb or cervix becomes infected after surgery. This can lead to:
- heavy bleeding
- vaginal discharge that is smelly or unpleasant
- a fever (temperature over 38°C/100.4°F)
- stomach cramps
Most infections can be successfully treated using a short course of antibiotic tablets.
Excessive bleeding
Excessive bleeding, during or after surgery, occurs in around 1 in 400 cases. This can occur if a blood vessel is accidentally damaged.
If the bleeding begins during surgery the surgeon may be able to stem the bleeding by increasing the amount of fluid or gas in the womb. Often the increase in pressure helps to stop the bleeding.
If bleeding persists after surgery then one option is to insert a small balloon filled with fluid inside the womb. Much like gas or fluid, the pressure of the balloon helps stem the bleeding. The balloon is then removed 24 hours later.
An alternative method is to use medications such as vasopressin, which narrows the blood vessels and can help reduce bleeding.
Occasionally it becomes necessary to plug the blood vessel shut with small pieces of plastic or gel (this is known as embolisation).
In rare cases that fail to respond to treatment it may be necessary to remove the womb (hysterectomy).
