Gynaecology - Hysteroscopy under General Anaesthetic (GA)

What is a Hysteroscopy?

A Hysteroscopy is a procedure that involves examining the inside of your uterus (womb).

This is done by passing a thin telescope-like device called a hysteroscope that is fitted with a small camera through the neck of your womb (cervix).

The doctor carrying out the procedure can then see whether there are any problems inside your womb that may need further investigation or treatment.

A hysteroscopy can help find out what is causing symptoms such as heavy periods, irregular bleeding and bleeding after the menopause.

Risks

• Perforation of the womb (risk 1 in 1000). Should this occur you may need treatment with antibiotics and a more prolonged stay in hospital

• Pelvic Infection (risk 1 in 400)

Before the Procedure

The procedure must not be performed if there is any chance that you are pregnant.

To avoid this possibility, it is important to use contraception or avoid sex between your last period and your appointment. You may be offered a urine pregnancy test on arrival at your appointment.

You may have already attended a pre-assessment clinic where routine health checks will assess your fitness for General Anaesthetic.

On admission to the ward or day services unit you will be prepared for theatre. Make sure you remove any make-up, nail varnish, jewellery and body piercings. Advise nursing staff of any jewellery or piercings that you are unable to remove.

It is important to advise the nurse and anaesthetist if you are wearing dentures.

During the Procedure

You will be given a General Anaesthetic in theatre which means you will be asleep during the procedure. Your anaesthetist will discuss this with you prior to the surgery.

A thin telescope (hysteroscope) with a camera attached is gently passed through the neck of your womb. Clear fluid or gas is passed through the telescope to dilate the womb and allow all surfaces to be seen.

A small sample of the lining of the womb (a biopsy) can then be taken and sent to the laboratory for examination. Polyps/fibroids can be removed and sent for examination.

Intrauterine contraceptive devices (coils) and Mirena coils can be removed or fitted at the same time.

The procedure takes between 10 and 20 minutes to complete. At the end of the procedure you will spend a short time in a recovery area before returning to the ward.

After the Procedure

On return to the ward you will need to rest on your bed while the effects of the General Anaesthetic start to wear off.

As the anaesthetic wears off, you may have period-like cramps, and or feel sickly. If you do have pain or sickness, inform the nurse who will give you medication as required.

Once assessed as medically fit, you will be discharged home. You will need to arrange for someone to drive you home, and if you live alone you need to have a responsible adult with you for 24 to 36 hours.

It is normal to bleed for up to 10 days. During this time, to reduce the risk of infection, avoid using tampons and sexual intercourse.

You will feel tired for up to 3 days afterwards, however symptoms usually settle very quickly.

Advice following anaesthetic

General anaesthesia can affect your coordination. Your judgement and reaction times may be impaired, therefore:
●    It is important to remain in the company of a responsible adult for the next 24 to 36 hours. During this time you should not drink alcohol, make any important decisions or sign any important documents
●    Do not drive, operate machines, cookers or ride a bicycle for 48 hours, this may be longer depending upon the type of operation

When to seek medical advice?

You must contact your GP or seek urgent medical advice (depending on severity of symptoms) if you develop any of the following:
●    Prolonged heavy bleeding
●    Severe pain
●    Pain that lasts over 48 hours
●    High temperature
●    Vaginal discharge that smells unpleasant

These are all signs of a pelvic infection that may need treatment with antibiotics.

Follow up and Results

If you have a biopsy, polyp(s) or fibroids removed and sent for examination, the results will be reviewed and a letter sent to you and your GP with the findings.

If further treatment is required/recommended, an appointment will be made for you to return to clinic to discuss with your doctor.
 
Contact Telephone Numbers

The Royal Oldham Hospital
Gynaecology Assessment Unit (GAU): 0161 627 8855

Rochdale Infirmary
Day Surgery: 01706 557133