Hysteroscopy (Diagnostic and Operative)

Bleeding between periods, bleeding after menopause, or a scan report that says "thickened endometrium" without saying why. For other women it's a string of failed pregnancy tests or miscarriages. In each case the answer often lies inside the uterine cavity, which an ultrasound can only partly show.

A hysteroscopy uses a thin telescope with a light and camera (a hysteroscope), passed through the vagina and cervix into the uterus. Sterile fluid gently opens up the cavity so the doctor can see the lining clearly on a screen. In a diagnostic hysteroscopy the doctor looks and may take a small sample. In an operative hysteroscopy, fine instruments passed through the scope remove polyps, fibroids, a septum or scar tissue.

There are no cuts on your abdomen, and most women go home within a few hours. The doctor can usually tell you what was seen the same day, and any biopsy report follows in about a week. Many problems, a polyp for example, are found and fixed in one go.

Hysteroscopy has its own dedicated suite in our gynaecology department. We use it to investigate problems inside the uterus and to treat fibroids and other growths in the cavity, often in the same visit.

Hysteroscopy is the most direct way to see the inside of the uterus. It's usually suggested after an ultrasound raises a question or doesn't explain your symptoms.