Dr. Ritika Gupta

Consultant Obstetrician & Gynaecologist
Laparoscopic & Robotic Surgeon
MBBS, MS (Obs & Gyn), FMAS, DMAS, Dip. USG

HYSTEROSCOPY – A SIMPLE GUIDE FOR PATIENTS

Understanding the procedure. Knowing why it is advised. Reducing fear and uncertainty.

Hysteroscopy is a commonly recommended gynecological procedure, yet it often causes anxiety simply because many patients are unfamiliar with what it involves.

This guide explains hysteroscopy in clear, simple language, helping you understand why it is advised, how it is performed, and what to expect, so that decisions feel informed rather than rushed.

WHAT IS HYSTEROSCOPY?

Hysteroscopy is a minimally invasive procedure that allows direct visualisation of the inside of the uterus using a thin, lighted instrument called a hysteroscope.

The hysteroscope is passed gently through the vagina and cervix into the uterine cavity.
No abdominal cuts or stitches are required. Because hysteroscopy uses the natural vaginal route, it is often referred to as a scarless procedure.

WHY IS HYSTEROSCOPY ADVISED?

Hysteroscopy may be recommended to:

  • Diagnose the cause of abnormal uterine bleeding
  • Evaluate the uterus in infertility
  • Assess or treat recurrent pregnancy loss
  • Remove uterine polyps or small fibroids
  • Correct uterine cavity abnormalities

It allows the doctor to see the uterine cavity directly rather than relying only on scans.

DIAGNOSTIC vs OPERATIVE HYSTEROSCOPY

Diagnostic Hysteroscopy

Used to look inside the uterus to identify abnormalities.

Common reasons include:

  • Irregular or heavy periods
  • Suspected uterine polyps
  • Evaluation before infertility treatment

Operative Hysteroscopy

Used to treat a problem during the same procedure, if identified.

This may involve:

  • Polyp removal
  • Submucous fibroid removal
  • Septum correction
  • Removal of retained tissue

In many cases, diagnosis and treatment can be done together.

COMMON CONDITIONS TREATED WITH HYSTEROSCOPY

Hysteroscopy is particularly helpful for conditions affecting the uterine cavity, such as:

  • Endometrial polyps
  • Submucous fibroids
  • Uterine septum
  • Adhesions (scar tissue)
  • Abnormal uterine bleeding with unclear cause

These conditions may not always be accurately identified by ultrasound alone.

IS HYSTEROSCOPY PAINFUL?

Most patients tolerate hysteroscopy well.

  • Diagnostic hysteroscopy often causes mild discomfort or cramping
  • Operative hysteroscopy may be done under short anaesthesia for comfort

Pain perception varies, and the approach is tailored to:

  • The procedure being performed
  • Patient comfort
  • Clinical requirement

The aim is always to keep the experience safe and comfortable.

HOW IS HYSTEROSCOPY PERFORMED?

The procedure generally involves:

  • Short admission or day-care setting
  • Gentle insertion of the hysteroscope
  • Expansion of the uterine cavity for visibility
  • Visual assessment and treatment if needed

Most procedures take 15–30 minutes, depending on complexity.

RECOVERY AFTER HYSTEROSCOPY

Recovery is usually quick.

Most patients experience:

  • Mild cramping for a short time
  • Light spotting for a day or two
  • Ability to resume normal activities within 24 hours

Hospital stay is often not required, and patients return home the same day.

WHEN IS HYSTEROSCOPY USEFUL IN INFERTILITY?

Hysteroscopy plays an important role in infertility care by:

  • Identifying uterine cavity abnormalities that affect implantation
  • Correcting correctable anatomical issues
  • Improving outcomes before fertility treatments

It is recommended only when clinically useful, not routinely for every patient.

IS HYSTEROSCOPY SAFE?

Hysteroscopy is considered a safe procedure when performed by trained specialists.

Potential risks are uncommon but may include:

  • Infection
  • Bleeding
  • Uterine perforation (rare)

These risks are minimised by:

  • Proper patient selection
  • Careful technique

Performing the procedure in an equipped medical facility

COMMON MYTHS ABOUT HYSTEROSCOPY

Myth: Hysteroscopy always requires hospital admission
Fact: Most procedures are done as day-care surgery

Myth: It affects future fertility negatively
Fact: When indicated, it often improves fertility outcomes

Myth: It is a major surgery
Fact: It is a minimally invasive procedure

FREQUENTLY ASKED QUESTIONS

Will hysteroscopy affect my periods?

Periods usually return to normal quickly after the procedure.

Can hysteroscopy be done during periods?

It is usually planned after periods, but timing is individualised.

Is bed rest required?

No. Normal activities can usually be resumed the next day.

Is hysteroscopy needed for everyone with infertility?

No. It is advised selectively, based on findings and symptoms.

A REASSURING FINAL NOTE

Hysteroscopy is a valuable tool that allows precise diagnosis and treatment without major surgery.

When advised thoughtfully, it can:

  • Clarify the cause of symptoms
  • Avoid unnecessary treatments
  • Improve fertility outcomes
  • Provide reassurance through accurate diagnosis

If hysteroscopy has been recommended, a consultation allows you to understand why it is needed, what it involves, and what outcomes to expect, so that decisions feel confident and informed.