Dilatation and curettage (D&C)

Read about what happens before and during a hysteroscopy, including what you need to do to prepare and what happens while the procedure is carried out.

A hysteroscopy is a simple procedure usually carried out on an outpatient or day-case basis. This means you won't normally need to stay in hospital overnight.

Preparing for a hysteroscopy

In the days and weeks before a hysteroscopy, you may be advised to:

  • have tests to check whether you can have the procedure, such as blood tests and a pregnancy test – these may be done at an appointment about a week before your hysteroscopy
  • use contraception – a hysteroscopy can't be carried out if you're pregnant
  • stop smoking – if you're due to have a general anaesthetic and you smoke, stopping smoking in the lead up to the procedure can help reduce your risk of complications from the anaesthetic

If you're going to have fibroids removed, you may be given medicine to help shrink them beforehand.

Choice of anaesthetic

A hysteroscopy isn't usually carried out under anaesthetic, as it's a relatively quick procedure and doesn't involve making cuts (incisions) in your skin.

The procedure shouldn't be painful, although you may experience some discomfort, similar to period pain. Taking painkillers such as ibuprofen or paracetamol about an hour beforehand can help reduce this.

Occasionally, a local anaesthetic may be used to numb your cervix (entrance to the womb) during the procedure.

Longer or more complicated procedures, such as the removal of fibroids, may be done under general anaesthetic. This means you'll be asleep while the operation is carried out.

On the day of your hysteroscopy

If you're having a general anaesthetic, you'll need to avoid eating or drinking for a few hours before the procedure. Your appointment letter will mention whether this applies to you.

If you're having no anaesthetic or just a local anaesthetic, you can eat and drink as normal.

It's a good idea to wear loose, comfortable clothes when you arrive for your appointment, as you'll be asked to remove any clothes from below your waist and change into a hospital gown for the procedure.

You can bring a friend or relative with you for support, although they may not be allowed in the room during your hysteroscopy.

The hysteroscopy procedure

A hysteroscopy usually takes between 5 and 30 minutes. During the procedure:

  • you lie on a couch with your legs held in supports and a sheet is used to cover your lower half
  • an instrument called a speculum may be inserted into your vagina to hold it open (the same instrument used for a cervical screening test), although this isn't always needed
  • the vagina and cervix are cleaned with an antiseptic solution
  • a hysteroscope (long, thin tube containing a light and camera) is passed into your womb – you may experience some cramping and discomfort as it passes through your cervix
  • fluid is gently pumped into the womb to make it easier for your doctor to see inside
  • the camera sends pictures to a monitor, so your doctor or specialist nurse can spot any abnormalities

In some cases, a small sample of tissue from the womb lining may be removed for further testing. This is known as an endometrial biopsy.

If you're having a hysteroscopy to treat a condition such as fibroids or polyps, fine surgical instruments can be passed along the hysteroscope. These are used to cut or burn away the abnormal tissue.

After a hysteroscopy

You should be able to go home soon after a hysteroscopy, although you may need to stay in hospital for a few hours if you had a general anaesthetic.

Your doctor or nurse will discuss their findings with you before you leave, although it may take a few weeks to get the results of a biopsy.

You can usually return to your normal activities later the same day or the following day if no anaesthetic or just a local anaesthetic was used. If you had a general anaesthetic, you may need to take things easy for a day or two.

Read more about recovering from a hysteroscopy.

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