Operative Hysteroscopy

Operative hysteroscopy uses a camera through the cervix to diagnose and treat selected problems inside the womb.

The hysteroscope passes through the vagina and cervix, so there is no abdominal cut. Small instruments or energy devices can remove a polyp or fibroid, divide scar tissue, or reshape a uterine septum. The procedure may be scheduled after imaging, fertility assessment or an earlier diagnostic hysteroscopy.

Most people have cramping and light vaginal bleeding or watery discharge for a short time. Take only the pain relief advised for you, use pads while bleeding continues, and avoid penetrative sex, tampons and swimming until your care team says the cervix and womb have recovered.

You may feel tired after sedation or anaesthesia, so arrange transport and an adult nearby if instructed. Return to normal activity gradually. Heavy bleeding, fever, severe pain, faintness or foul-smelling discharge needs prompt medical advice.

The exact likelihood varies with the treatment, the size and position of the problem, and your health. Possible complications include infection, heavy bleeding, a tear or hole in the womb, fluid absorption problems, cervical injury, incomplete treatment and scar tissue returning. Ask how these risks apply to your planned procedure and what warning signs need urgent help.

Operative hysteroscopy can remove a visible polyp or fibroid, divide adhesions, or correct a septum, but the outcome depends on the underlying condition and the completeness of treatment. Scar tissue or fibroids can recur, and bleeding or fertility problems may have more than one cause. Your clinician can explain whether repeat imaging, hysteroscopy or other care is expected.

The procedure treats the cavity of the womb rather than the outside wall. A fluid medium gently opens the cavity so the surgeon can see. Tissue removed during treatment may be examined in a laboratory. Pregnancy plans, contraception and the timing of future fertility treatment should be agreed before the procedure.

It may be offered for heavy or irregular bleeding caused by a cavity problem, an endometrial polyp, a submucosal fibroid, adhesions in Asherman Syndrome, or a uterine septum. It can also be considered during assessment of recurrent miscarriage when the womb’s shape or cavity needs treatment.

After consent and anaesthetic planning, you are positioned for the procedure. The hysteroscope passes through the cervix while fluid opens the cavity. The surgeon inspects the lining, uses a small instrument to treat the target, checks for bleeding, and sends removed tissue for examination when needed. You then recover while staff monitor you.

Many people go home the same day, although the plan depends on anaesthesia and the complexity of treatment. Cramps can feel like period pain. Keep the discharge instructions available, drink as advised, and arrange follow-up so the team can review symptoms, pathology and plans for trying to conceive.

A hysteroscope cannot treat every cause of pelvic pain, bleeding or infertility. The view may be limited by cervical narrowing, bleeding or a cavity that is difficult to expand. Complications can require antibiotics, observation or another procedure, although the team takes steps to reduce these risks.

Alternatives depend on the finding and may include observation, medication, an ultrasound-guided approach, an abdominal operation or fertility treatment without cavity surgery. A diagnostic hysteroscopy may be used when the aim is inspection rather than treatment. Discuss how each option fits your symptoms and pregnancy plans.

Choose a gynaecology service that can explain the cavity problem, the planned instrument, anaesthesia, fluid monitoring and follow-up. Ask what to do about medicines, bleeding, contraception and future pregnancy before you sign consent.