Outpatient Hysteroscopy (OPH) is a procedure that is designed to examine the inside of the uterus (womb). It involves passing a hysteroscope – a thin telescopic device with a small camera- through the cervix (neck of the womb). The procedure is done to investigate whether there are problems with the uterus and if further investigation or treatment is needed.
The Need for Outpatient Hysteroscopy
The purpose of OPH is to find the cause of your problem concerning the uterus and to plan or undertake treatment if necessary.
You may undergo OPH if you are experiencing or have experienced the following issues:
- Abnormally heavy periods
- Postmenopausal bleeding
- Bleeding between periods
- Irregular bleeding while on hormonal treatment
- Fertility concerns
- Removal of a coil when the threads cannot be seen at the cervix
- Following a miscarriage
- To investigate something that has been sighted inside the uterus during an ultrasound scan such as fibroid or endometrial polyp
You will be given some pre-op guidelines that should be followed before the procedure. They include:
- Drink or eat in small portions a few hours before the procedure
- Take pain relief medication an hour before the procedure
- Go with a list of medications that you are currently taking
- You can be accompanied by a friend or family member
You will undergo a pregnancy test before the procedure to rule out the possibility of you being pregnant. OPH cannot be performed on pregnant women or if you are heavily bleeding.
Other things to consider whether you are a good candidate for OPH include if you:
- If you faint due to period pain
- Have experienced severe pain during previous vaginal examination
- Have experienced painful or difficult cervical smears
- Have had a traumatic experience in the past that might make the procedure difficult for you
- Do not want to undergo the examination when you are conscious
What to Expect During OPH
OPH can be done under either spinal or general anesthetic as a day-case procedure in an operating theatre.
Before the examination, your doctor will ask you some questions and perform an ultrasound scan if you had not recently undergone any. During this time you can ask any questions that you may be having.
A nurse will then help you get positioned in a special chair and keep you as covered as possible.
Your doctor will then pass a hysteroscope through the cervix to get a clear view of the inside of the uterus. A saline solution will be used to help the doctor view the inner lining of the uterus and you may feel as the fluid trickles out. The procedure will take about 10-15 minutes if no problems are found. Sometimes, a biopsy from the lining of your uterus may be taken and sent to the laboratory for examination.
If a polyp or fibroid is found, it can sometimes be removed at the same time using additional instruments inside the hysteroscope.
Other minor procedures that can be done during OPH include insertion of a hormone-releasing intrauterine device and coil removal.
What to Expect After the OPH Procedure
After the examination, you may experience period-like pain for about a day or two. You may also have some spotting or bleeding (bright red blood) for a week. Most women can resume their activities on the same day and can shower as normal.
However, the resumption of physical activities including intercourse can be resumed when the discomfort and bleeding have stopped. If necessary, you may take pain relief medication or your normal period pain tablets.
If no problems are found, follow-up appointments are not necessary. If a biopsy has been taken, you will receive the results as soon as they are available, and your doctor will discuss the next steps with you.