Dilatation and curettage (D&C) - How a hysteroscopy is performed

Before having a hysteroscopy, you may need to do a few tests to check whether you can undergo surgery.

These may include blood tests, a pregnancy test and a cervical smear test, which will check for any infections or abnormalities with your cervix.

GnRH agonists

If you are having a hysteroscopy to remove abnormal tissue growth, such as fibroids or polyps, you may be given a type of medication called a gonadotropin-releasing hormone (GnRH) agonist. If you are given these, you will have to take them for a little while before you have surgery.

This may help shrink abnormal tissue growth, which will increase the chances of successful surgery and reduce the risk of excessive bleeding.

GnRH can cause menopausal-like side effects, such as hot flushes and excessive sweating. However, these should go away when you stop taking the medication.

Choice of anaesthetic

You can have a hysteroscopy either with or without a local anaesthetic, depending on what type of procedure you are having. It will usually be carried out in the outpatients department of a hospital.

Having a hysteroscopy is similar to having a smear test, but takes a little longer. It should not hurt. There is usually some discomfort, similar to period pain. If you are not having any anaesthetic, you may wish to take a painkiller, such as ibuprofen, beforehand.

The procedure can also be carried out under general anaesthetic (when you are asleep) as a day case operation. This may be recommended if your surgeon expects to do extensive treatment at the same time, or if you request it.

The procedure

The surgeon will gently put an instrument called a speculum into your vagina. This holds the walls of the vagina open, enabling easy access to your womb.

Next, the vagina and cervix are cleaned with an antiseptic solution. The surgeon will then insert the hysteroscope through your cervix, into your womb. A hysteroscope is a long, thin tube with a light source and a camera on the end.

As the womb is small, gas or fluid may be pumped inside to make it larger. This helps the surgeon see the lining of the womb, and any abnormalities, more clearly. The camera at the end of the hysteroscope sends pictures from the inside of your womb to a video screen.

Surgical instruments similar to a hysteroscope can also be passed into your womb, if required, where they can be used to cut or burn away abnormal tissue growth. Tissue can be removed using a number of techniques such as lasers, an electrical current and specially designed blades.

A sample of tissue can also be removed for further testing (biopsy) if required.

A hysteroscopy usually takes between 10 and 30 minutes, depending on what needs to be done. You will need some recovery time after the procedure.