Dilatation and curettage (D&C)

A hysteroscopy is a procedure used to examine the inside of the uterus (womb).

It's carried out using a hysteroscope, which is a narrow tube with a telescope at the end. Images are sent to a computer in order to get a close-up of the womb.

Why it is used

A hysteroscopy can be used to diagnose cases when a woman’s symptoms suggest there could be a problem with their womb. Symptoms can include:

heavy periods or irregular periods
bleeding between normal periods, after sexual intercourse or after menopause
pelvic pain
unusual vaginal discharge
repeated miscarriage
infertility

A hysteroscopy can also be used to remove abnormal growths from the womb, such as:

fibroids – non-cancerous growths that can develop inside the womb and can sometimes cause symptoms such as pain and heavy periods
polyps – small growths that develop on the lining of the womb and can cause irregular and heavy periods
intrauterine adhesions – sections of scar tissue that can cause absent periods and infertility
thickening of the uterus' lining (endometrial hyperplasia) – this can increase the risk of womb cancer

A procedure called dilatation and curettage (D&C) used to be commonly used to examine the womb and remove abnormal growths, but nowadays hysteroscopies are carried out instead.

What happens during a hysteroscopy

A hysteroscopy is a common procedure that is often carried out on an outpatient basis. This means you do not have to stay in hospital overnight.

It can be performed under local anaesthetic (when medication is used to numb a small area) or general anaesthetic (when you are asleep during the procedure), depending on the reason for your hysteroscopy.

The surgeon will use a device called a speculum to open up the walls of the vagina, in the same way it is used during a cervical smear test. The surgeon will then insert the hysteroscope through the cervix, into the womb.

Gas or fluid is often used to inflate the womb, to give the surgeon a better view.

If a biopsy or treatment is needed, such as the removal of polyps, other instruments will be passed into the womb.

A hysteroscopy usually takes between 10 and 30 minutes, depending on what needs to be done.

Read more about how a hysteroscopy is performed.

Recovering from a hysteroscopy

Some women will experience cramping similar to period pains after a hysteroscopy, but this usually passes after a few days.

Most women feel they can return to normal activities, such as work, the day after the procedure.

Read more about recovering from a hysteroscopy.

Risks

A hysteroscopy is a very safe procedure, with a low risk of complications.

The two most commonly reported complications of a hysteroscopy are:

accidental damage to the womb or cervix, which may require further treatment to correct – this occurs in around 1 in 135 cases
excessive bleeding during or after surgery, which happens in around 1 in 400 cases

In almost all cases, the benefits of having a hysteroscopy far outweigh the potential risks.

Read more about the risks of having a hysteroscopy.