Outpatient Hysteroscopy clinic

What is a hysteroscopy?

A hysteroscopy is a procedure used to look into the womb. This is done with a hysteroscope, which is a thin telescope with a camera at the end. On average, an outpatient hysteroscopy lasts about 15–20 minutes.

Why is a hysteroscopy recommended?

A hysteroscopy may be recommended for:

  • Heavy, painful or irregular periods
  • Bleeding between your periods
  • Bleeding after the menopause
  • Problems with fertility
  • An enlarged womb/ fibroids in the womb
  • Polyps in the womb
  • Insertion / removal of a coil

What happens if I cannot have smear or find them intolerable?

If you cannot tolerate a cervical smear then an outpatient (awake) hysteroscopy should not be recommended. Please discuss this with our healthcare practitioner as a general anaesthetic may be more appropriate.

What will happen when I attend?

You will be seen by the Specialist Nurse or Doctor.

  • You will be asked about the problem which led to this appointment.
  • Written, informed consent will be taken for this procedure or confirmed, if previously done

What if I am bleeding on the day of the hysteroscopy?

Please still attend your appointment even if you are bleeding or having a period so we can assess you as we may still be able to do the procedure.

Preparation for Outpatient Hysteroscopy

Allow a couple of hours to be in the hospital and you are advised not to return to work afterwards. You may bring a friend or family member for support.

An outpatient hysteroscopy is performed while you are awake and does not require a general anaesthetic. You are advised to:

  • Eat a light meal before your appointment.
  • Take simple painkillers, such as Paracetamol and Ibuprofen, 1 hour before your appointment (if not allergic/intolerant).

Use contraception if you have sexual intercourse one month before the procedure – you must use an effective form of contraception from the time of your previous period until you have the hysteroscopy.

You make be required do a pregnancy test before the procedure. We cannot do the procedure if there is any chance of pregnancy.

How is a Hysteroscopy performed?

During the procedure, you lie on your back on a special couch with your legs supported by stirrups. This is similar position to having a smear test.

About 1 in 3 women will have a local anaesthetic to the cervix (neck of the womb). 

A thin telescope (hysteroscope) is inserted through the cervix via the vagina. The hysteroscope is used to view the inside of the womb. The images are shown on a screen and you may watch the procedure, if you wish.

A sample of the womb lining may be taken for further investigation under a microscope. If polyps are seen, these may also be removed (polypectomy).

Is a hysteroscopy painful?

For most women, OPH is quick and safe, and is carried out with little pain or discomfort. OPH is usually done without inserting a speculum, by using a thin telescope (called vaginoscopic OPH) as this is more comfortable.

However, everyone’s experience of pain is different and some women will find the procedure very painful. If it is too painful for you, let your healthcare professional know as the procedure can be stopped at any time if you wish.

Your healthcare professional may offer a local anaesthetic injection into your cervix. This will require using a speculum to see your cervix and your healthcare professional will discuss this with you.

If you feel anxious about the procedure, you should talk to your doctor or nurse specialist before your appointment. 

After the procedure

After the examination, if you need to rest, a recovery area is available until you are ready to go home. You may feel a little sick or have some period type pains but these are usually only for a short while.

It is usual to have some light bleeding for a few days/a week after your hysteroscopy. As there is a small risk of developing an infection after your hysteroscopy, we recommend that you:

  • Use sanitary towels rather than tampons until the bleeding has stopped
  • Normal physical activity and sex can be resumed when any bleeding and discomfort has settled
  • Do not go swimming until the bleeding has stopped

You will not receive any drugs that affect driving, operating machinery or drinking alcohol.

If you any have questions before or after you leave remember any member of the team will be happy to discuss these with you – do ask us.

The RCOG information leaflet will also provide more information:

Results of the hysteroscopy

Following the hysteroscopy a member of the team will discuss the findings and implications with you.

Test results are usually discussed in a telephone follow-up and sent in writing you and your GP. If necessary, a clinic appointment will be arranged.

Further information

Take home messages

  • Outpatient hysteroscopy is an awake procedure
  • It is a simple assessment of the womb cavity
  • You must be able to tolerate a smear
  • Allow 2 hours for your visit
  • Take simple painkillers 1 hour before the procedure
  • Eat and drink normally beforehand
  • A local anaesthetic may be used
  • Bleeding may occur for a few days afterwards
  • Results will be done as a telephone appointment

Contact information

Chelsea and Westminster Hospital

Outpatient Hysteroscopy Clinic
Lower Ground Floor Outpatients, Gate 2

If you have questions or concerns about the procedure, please contact us:

E: chelwest.oph@nhs.net
T: 07468 740422

West Middlesex Hospital 

Gynaecology Outpatient Department
Twickenham House, First Floor

If you have questions or concerns about the procedure, please contact us:

E: chelwest.westmid.oph@nhs.net

Appointments

If you would like to change or cancel your appointment, please contact our appointments team:

Contributors
Camelia King-Martey