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Hysteroscopy, patient information

Hysteroscopy is a surgery during which a physician can look inside a patient’s uterus. It is used to find and often eliminate the cause of uterine bleeding, to remove myoma nodes and polyps in the lining of the uterus or to completely remove the lining of the uterus. In the case of infertility, adhesions or septa are searched for and removed from the uterus. Hysteroscopy is both a diagnostic and a therapeutic procedure. The surgery is performed under general anaesthesia.

Do not drink or eat, chew gum or smoke on the morning of the hysteroscopy.

Description of the procedure

During the procedure, the cervix is dilated, a hysteroscope is inserted into the uterine cavity and the cervix is filled with sterile fluid. This pushes the uterine walls away from each other for better visibility in order to assess the mucosa and manipulate the space in the uterine cavity. All instruments necessary for sampling and/or surgery are inserted into the uterus through a hysteroscope. Myoma nodes, polyps and tissues are cut electrically. After hysteroscopic surgery, there is often watery, foul-smelling vaginal discharge that can last up to a month. This does not indicate inflammation but is the result of using electrical instruments during surgery.

Tissue samples removed during the procedure are sent for histological examination, which examines the cellular structure of the tissue sample. After two weeks, the test response will be sent to the physician who referred you to hysteroscopy.

Possible complications

Complications associated with hysteroscopy are usually rare (1: 100).

  • The most common complication is bleeding due to injury to the uterine wall. If the injury only affects layers close to the uterine cavity; bleeding can be stopped inside the uterine cavity during hysteroscopy. A full-wall lesion may require additional laparoscopic surgery to stop the bleeding. Very rare uncontrolled bleeding may require removal of the uterus to save the patient’s life.
  • Injuries to other internal organs (intestines, bladder, blood vessels) are very rare. As a result of such complications, it is necessary to open the abdominal cavity with a traditional abdominal incision and correct the injury.
  • Uterine inflammation may occur following hysteroscopy, which requires antibacterial therapy.
  • Anaesthesia-related complications are also possible. These are mostly associated with hypersensitivity to medications.

Postoperative period

  • After the surgery, it is recommended to avoid lifting weights (over 5-6 kg) and heavy physical work for a few weeks.
  • After surgery, there may be a spotting or vaginal bleeding for a few weeks. Sexual intercourse is not allowed during this time.
  • It is not allowed to take a bath, go to the sauna, swim or use vaginal tampons for two weeks after the surgery.

Please note! In the case of heavy bleeding, fever or abdominal pain, contact our paid information line 1500 for initial counselling, which will refer you to a doctor if necessary, or go to the nearest Women’s Clinic emergency department (in Tallinn: East Tallinn Central Hospital at 18 Ravi Street or West Tallinn Central Hospital, also known as Pelgulinna Maternity Hospital at 23 Sõle Street.