Dilatation and curettage (D&C) - Risks of hysteroscopy

Complications after a hysteroscopy are rare, but can include accidental damage, excessive bleeding or infection.

Accidental damage

Accidental damage to the womb or cervix is the most common complication of a hysteroscopy. This happens in around 1 in every 135 cases.

A section of the cervix can sometimes tear, or the lining of the womb can sometimes become perforated (a hole is made in it).

Minor damage that does not cause excessive bleeding is not usually a cause for concern. However, if a more serious injury is suspected, you may need a procedure known as a diagnostic laparoscopy. This is where a tiny camera is passed into your womb, through an incision in your abdomen, to look at the damage.

In rare cases (around 1 in every 700) further surgery is then needed to repair the damage.

Excessive bleeding

Excessive bleeding during or after surgery occurs in around 1 in 400 cases. This happens because a blood vessel is accidentally damaged.

If the bleeding begins during surgery, the surgeon may be able to stem the bleeding by increasing the amount of fluid or gas in the womb. This will usually stop the bleeding.

If bleeding continues after surgery, a small balloon filled with fluid can be inserted inside the womb. Much like gas or fluid, the balloon's pressure can help stem the bleeding. The balloon is then removed after 24 hours.

An alternative method is to use medications such as vasopressin, which narrows the blood vessels, or tranexamic acid, which helps stabilise blood clots.

It can sometimes be necessary to plug the blood vessel shut with small pieces of plastic or gel (known as embolisation). 

In very rare cases, if the above methods don't work, it may be necessary to remove the womb (hysterectomy).

Infection

Occasionally, the womb or cervix can become infected after surgery. This can lead to:

• heavy bleeding
• vaginal discharge that is smelly or unpleasant
• a fever (temperature over 38°C/100.4°F)
• stomach cramps

If you experience any of these symptoms, it's important to either contact the hospital or your own GP. Most infections can be treated using a short course of antibiotics.