If you have been offered a diagnostic hysteroscopy, also known as outpatient hysteroscopy, then you will naturally have a number of questions ahead of your appointment. In this post, our experts will aim to answer some of the most commonly asked questions about the procedure, so that you know what to expect. We’ll also explain the diagnostic hysteroscopy procedure steps, as well as providing tips on how to prepare for your appointment.
What is a diagnostic hysteroscopy?
A diagnostic hysteroscopy is an examination of the inside of the uterus (womb) using a slim telescope (hysteroscope) with a light and camera on the end. The instrument is very thin, only around 3-5mm in diameter, and is passed through the vagina and cervix into the uterus by an experienced medical consultant.
The procedure is performed on an outpatient basis, sometimes with a local anaesthetic, but often without. It lasts for around 15-20 minutes, although it may take longer depending upon the reason for the procedure.
What is a diagnostic hysteroscopy used for?
The purpose of a diagnostic hysteroscopy is to discover the cause of any issues that you may be experiencing.
If you are commencing a fertility treatment journey, an outpatient hysteroscopy can prove helpful in uncovering and sometimes treating certain problems that may be affecting your fertility, or impacting upon your chances of carrying a pregnancy full term, such as endometrial polyps.
Typically, a hysteroscopy procedure will be suggested if you are suffering from very heavy periods, bleeding between periods, or irregular bleeding whilst on hormonal treatment, including contraceptives or hormone replacement therapy.
It may also be offered following a miscarriage, or to further investigate something that came to light during an ultrasound scan, such as an endometrial polyp. In some cases, a hysteroscopy can also be used to remove a contraceptive coil where the threads cannot be seen at the cervix.
Sometimes, a minor procedure can also be carried out during a diagnostic hysteroscopy. Such procedures may include an endometrial biopsy where a sample is taken from the uterine lining; polyp removal, or insertion of a contraceptive device, such as the Mirena coil.
How does the diagnostic hysteroscopy procedure work?
During an outpatient hysteroscopy, the medical consultant will use the camera to look inside your uterus. They will view the images on a computer screen, which you will also be able to look at should you wish.
Photographs are usually recorded of their findings, and kept on your healthcare notes.
Sometimes, the procedure may involve removing small polyps (small growths on the inside of the uterus), or taking a biopsy (tissue samples). If this is the case, it may take a little longer than the standard 15-20 minutes.
You should, as a rule, allow around an hour for your appointment, including preparation and recovery time.
How should I prepare for my outpatient hysteroscopy appointment?
You can eat and drink normally ahead of your appointment, as it’s not necessary to fast.
Pain relief is recommended at last one hour before the procedure, which could be ibuprofen or paracetamol, or whatever you find helpful for period pain.
You should bring with you a list of any medications that you are taking.
If you are bleeding, then you are advised to keep your appointment. It can sometimes be difficult to complete the procedure if bleeding is particularly heavy, so if you have any concerns, you should contact your healthcare professional in advance.
The pre-procedure pregnancy test
It is vital that a diagnostic hysteroscopy is not carried out if there is any chance you are pregnant. It is therefore essential that you use contraception or avoid sex between your last period and the appointment.
At Hull and East Riding Fertility, we always carry out a pregnancy test for women considered of childbearing potential ahead of performing a hysteroscopy.
You will be asked to provide the date of your last period, and whether you are using contraception, and then the nurse will ask for a urine sample so the pregnancy test can be carried out. You’ll be informed of the result, as will your medical consultant.
It is important to bear in mind that a pregnancy test may not always show a very early pregnancy. Therefore, if your last period was more than two weeks ago, and you have had unprotected sex during this time, then the procedure may need to be delayed until a pregnancy can be ruled out.
Does a diagnostic hysteroscopy hurt?
Most women experience minimal pain or discomfort during an outpatient hysteroscopy. However, pain tolerance will vary from one individual to another, and some may find the procedure more painful than others.
Mostly, the procedure is carried out without anaesthetic. Any slight discomfort can usually be managed by taking painkillers or anti-inflammatories ahead of the appointment. If you feel you may need a local anaesthetic due to individual circumstances, you should discuss this with your medical consultant.
If an endometrial biopsy is being undertaken during the procedure, this may involve inserting a speculum and passing a thin tube through the cervix, which could lead to severe period-like pain. However, this pain should not last for long.
If during any stage of the procedure you are finding it too painful, you can let your medical consultant know, and they will stop straight away.
In very few cases, a general anaesthetic may be required by some patients, or there may be a need for a more in-depth operative hysteroscopy procedure, for example where larger fibroids need to be removed. If a general anaesthetic is necessary you will be referred to an alternative clinic or hospital for the procedure to be carried out.
At Hull & East Riding Fertility, we have a team of highly experienced medical consultants, as well as state-of-the-art treatment facilities which allow us to undertake the diagnostic hysteroscopy procedures under local anaesthetic. For those who need the more complex operative procedure, however, we would make a referral to an alternative clinic.
Do I have to pay for a diagnostic hysteroscopy procedure?
In most cases, you will be offered a diagnostic hysteroscopy on the NHS, whereby you will be referred to a specialist hysteroscopy clinic, such as Hull & East Riding Fertility, by your GP or medical consultant.
However, you should be aware that NHS waiting times can be significant. You may already be on an NHS waiting list for the procedure.
If you are eager to have your symptoms investigated sooner rather than later, or keen to move on with your fertility treatment journey, then you may wish to go ahead on a private, self-funded basis, which you are always welcome to do.
How do I arrange a private, self funded, diagnostic hysteroscopy at Hull & East Riding Fertility?
At Hull & East Riding Fertility, we are able to offer the diagnostic hysteroscopy procedure on a self-funded basis, without any waiting list.
Our team of medical consultants is renowned for its specialist expertise in the area of diagnostic hysteroscopy. We have recently welcomed Medical Consultant Mugdha Kulkarni into the clinic. Mugdha is highly experienced in the field of outpatient hysteroscopy, and has been responsible for setting up and running clinics dedicated to the procedure.
To make an appointment, please contact the clinic on 01482 689040 or email enquiries@hullfertility.co.uk. We will make arrangements for you to see a specialist medical consultant, who will take time to understand your medical history, as well as invite you to ask questions about the procedure ahead of arranging your appointment.