Hysteroscopy and Endometrial Biopsy
Information for patients and carers on hysteroscopy and endometrial biopsy.
This page aims to give you some information about the hysteroscopy and endometrial biopsy and also to help to answer some common questions that you may have.
It is a guide and there will be an opportunity to discuss the treatment with the doctor at your appointment.
We hope by increasing your understanding of the treatment, you will feel less anxious when you come to clinic.
Where are we?
The Hysteroscopy Clinic is situated in the Gynae / Antenatal Clinic.
You may wish to bring a friend or relative to accompany you and take you home. They can be present during the examination if desired.
Why is a hysteroscopy performed?
Hysteroscopy is used to examine the inside of the womb (uterus). It is usually recommended when there are problems with irregular or abnormal bleeding, or to check the uterus before and after procedures or investigations for other problems.
What is a hysteroscopy?
A very fine telescope called a hysteroscope, with a light and a camera on one end, is passed through the cervix (neck of the womb) and into the womb (uterus).
Fluid is passed through the hysteroscope to open the womb so that a good view can be obtained. The image will be displayed on a monitor that you can watch if you wish. Photographs of the findings are taken and kept in your notes as part of the hospital record. A biopsy from the lining of the womb will be taken at the end of the procedure.
If your cervix is too tight it may need dilatation (stretching) which can be performed in an outpatient setting using local anaesthetic and gas & air (Entonox) or as an inpatient day case under general anaesthetic (GA) on another day.
Prior to your appointment:
- If you are on blood thinning medication, please contact the gynaecology secretaries on 01229 402503 FGH or 01524 551234 RLI or speak to your referring clinician for advice.
- It is advisable to use barrier contraception (like condoms) from the start of your period before the procedure and continue using them until after you have had the procedure.
If you have any worries or concerns before the procedure, please ring and ask to speak to a member of the hysteroscopy team. Contact details are at the end of this page.
On the day of the procedure:
- Eat something light before attending your appointment.
- If you are able to take ibuprofen or paracetamol, you are advised to take 400 mg of ibuprofen or 1 gram of paracetamol, 1 hour before the procedure (both medications are easily bought at supermarkets and chemists).
- If you are allergic to ibuprofen or similar pain relief (such as naproxen or aspirin) or are not able to take these for any reason, please check with your GP for a suitable alternative.
- If you are already taking paracetamol and / or ibuprofen regularly, you will not need to take extra, just continue with your normal dose.
- Bring a sanitary towel with you if you can. However, we can provide one for you if you do not have any.
- You may wish to bring a friend or relative to accompany you during the examination.
- It is important there is no risk of pregnancy when the procedure is carried out. Therefore, if you are of childbearing age, we will ask your permission to carry out a pregnancy test before we start. This will mean you have to give us a urine sample before we start the hysteroscopy. Your procedure will be cancelled if there is a possibility that you might be pregnant. As a precaution, it is advisable to use barrier contraception (like condoms) from the start of your period before the procedure, and continue using them until after you have had the procedure.
What will happen during the appointment?
On the day of your appointment you will see the doctor before the procedure for an assessment. This is a good time to raise any concerns or ask questions you may have, as it is important to us that you are involved in any decisions about your care and treatment.
You will be shown into the treatment room. A nurse and a health care assistant will be with you to ensure your comfort and help the doctor during the procedure. Please note that we are a teaching hospital so it is not unusual for trainee doctors or student nurses to be present during your appointment. If this makes you feel uncomfortable then do not hesitate to tell the nurse or doctor.
We will then ask you to lie on our couch in the same position as when you have a smear. A speculum will be inserted so the doctor can see your cervix.
The hysteroscopy will then begin.
Once the hysteroscope is inside your womb the procedure only takes a few minutes.
You may feel cramps like period pains as the fluid stretches your womb, although not everyone does. Do not worry if you feel wet or dribbling as this is due to the fluid we use.
At the end of the examination a small sample of the lining of the womb is usually taken and sent to the laboratory to be examined. This can feel like a sharp period pain which is why we ask you to take pain relief.
You will be kept fully informed during the procedure and can ask for it to stop at any time.
Your appointment will take about 30 minutes which includes the discussion with the doctor. However, as is the nature of hospital appointments, sometimes appointments may be late or overrun so please allow yourself additional time.
Are there any risks with the procedure?
There are risks with any operation, but these are small.
Possible complications are:
- Bleeding
- Infection
- Perforation of the uterus (making a hole in the womb). In most cases when a perforation occurs you may require admission and antibiotics treatment and this resolves without any further treatment. Rarely you may require further sugery to repair any adjacent local organ but this is very unlikely.
Occasionally symptoms may develop around 10 - 14 days following the procedure. These will be discussed with you when you sign your consent form.
If you develop:
- High temperature or strong smelling discharge.
- Lower abdominal pain.
- Heavy bleeding that is worse than a normal period or you are at all concerned then please contact your GP or Gynaecology Clinc for advice (contact details are at the end of this page).
After care:
There may be some slight bleeding over the next few days. This should not be heavier than a period and should gradually get less, becoming a brown discharge before it stops. You are advised to use sanitary towels rather than tampons while you have any bleeding or discharge.
You may experience some period type pain for the next few days. Take pain relief if required.
You are advised to avoid vaginal intercourse until the discharge stops.
If you find you have an increase in temperature, pain, offensive vaginal discharge or heavy bleeding, after the hysteroscopy then you should contact your GP or hospital for advice. Contact details are below.
If you had a biopsy taken, we will write to you with the result, between 2 - 4 weeks. If you require a further appointment, it will be sent through the post.
What should I do if I have a problem?
If you have any concerns following your treatment please do not hesitate to contact the hysteroscopy clinic team. We also advise you to contact your GP.
From Monday – Friday, 8:30am-4:30pm, please contact us on 01539 716998 and ask to speak to a member of the hysteroscopy team.
For any queries out of clinic and surgery hours, we advise you to contact:
- Ward 16 at Royal Lancaster Infirmary: telephone 01524 583820
- Ward 1 at Furness General Hospital: telephone 01229 87087
Date of publication: 12/06/2019
Reference code: PIL126/IND042
Review date: 01/06/2028