This page may be helpful if you are considering having a hysteroscopy under general anaesthesia. The purpose of this page is to tell you more about this procedure, why it is being done and what it involves.
A hysteroscopy is a minor surgical procedure that allows examination of the lining of the uterus (womb).
During a hysteroscopy a very slim telescope is advanced through the vagina and cervix, and into the uterus. This provides pictures of the lining of the uterus. The surgeon may take a biopsy (a small sample of tissue) through the telescope, or perform other small procedures.
We may offer a hysteroscopy:
- To investigate abnormal vaginal bleeding, including bleeding after the menopause
- To remove abnormalities of the uterus like polyps (small swellings of the lining of the uterus), small fibroids or adhesions (scarring).
- To remove contraceptive devices (if it is not possible to remove them during a normal examination).
- As part of fertility investigations.
- To check for signs of cancer.
A hysteroscopy is generally very safe, but like any procedure there is a small risk of complications.
The main risks of a hysteroscopy are:
- Infection: signs of an infection after hysteroscopy include offensive vaginal discharge, fever and abdominal pain. It can usually be treated with a short course of antibiotics.
- Accidental damage to the uterus: occasionally the instruments that we use can be advanced too far, or in the wrong direction, and cause a small hole in the uterus (a perforation). Outside the uterus, rarely, these instruments can cause damage to other organs in the pelvis. If this happens, you may require admission to hospital, antibiotics, or rarely an operation to check for/or repair any damage.
- Unsuccessful procedure: sometimes it is not possible to complete a hysteroscopy. This may be because the neck of the uterus is tightly closed (stenosed). If this happens, we will discuss alternative options with you.
We want to involve you in all the decisions about your care and treatment.
Your doctor will explain all the risks, benefits and alternative options to having the procedure. You should have the opportunity to ask any questions.
If you decide to go ahead with the hysteroscopy, we will ask you to sign a consent form. This is a record of the discussions we have had, and of your wish to have the procedure.
If you are unsure about any aspect of your proposed treatment, please don’t hesitate to speak with a senior member of staff again.
You will be asked to complete a pre-assessment questionnaire, answering questions about your general health and any medication you take. You may also be invited for a pre-assessment appointment in person or by telephone, or to attend for investigations (for example blood tests or an ECG).
If you are on your period on the day of the procedure, we will usually not be able to carry out the hysteroscopy, as the blood makes it difficult to see clearly. If you suspect your period may be due on the day of your appointment, please contact the team caring for you (contact numbers at the end of this booklet) to discuss.
It is very important that you are not pregnant when a hysteroscopy is carried out. If you are sexually active and have not gone through the menopause, you must use contraception from the time of your last menstrual period before your appointment. If there is any possibility you may be pregnant, please contact your team to discuss this further (contact numbers can be found at the end of this booklet). Please note that a pregnancy test first becomes positive approximately two weeks after you have conceived. This means that a negative pregnancy test cannot exclude a pregnancy if it is taken within two weeks of unprotected sex.
Before an operation under general anaesthetic, it is important that you stop eating and drinking so that your stomach is empty. The time you should stop eating and drinking will depend on the admission time you have been given.
| Admission time (arrival time given to you in a letter or message from the administrative team) | Stop eating any food, drinking fluids other than water, chewing gum or sucking sweets at: | You can drink unflavoured, non-fizzy drinks until: |
|---|---|---|
| 7AM – 9.30AM | Midnight | 6am |
| 11AM – 12.30PM | 6am | 2 hours before your admission time |
You should wear comfortable clothes, and bring any regular medication with you (including inhalers). Do not bring valuables into hospital with you. You should remove all piercings and jewellery before coming to hospital. Ideally at least one fingernail should not have dark or acrylic nail varnish on it.
You will be advised to go to either the Surgical Admissions Unit or the Day Surgery Unit at a certain time. Please check your admission letter for up-to-date information. You can usually be accompanied by one person while you wait, until you are ready to go to the operating theatre.
On arrival, you will usually be asked to provide a urine specimen to perform a pregnancy test. You will be seen by both a gynaecologist and an anaesthetist before the hysteroscopy is carried out. They will be able to answer any questions you may have and confirm that you wish to proceed.
When it is your turn to have your procedure, you will be escorted to the operating theatre. A cannula (drip) will be placed in your hand, and the general anaesthetic will be given to make sure you are asleep and do not feel anything during the procedure.
The doctor may use a speculum to view the cervix (the neck of your uterus). This is the same instrument used during a cervical smear. Your cervix may then be gently stretched using an instrument called a dilator. A hysteroscope is then used to look at the lining of your uterus by introducing saline into the cavity of the uterus to help provide a clear view. If necessary, a biopsy will be taken and sent to the laboratory for examination. Fibroids or polyps can also be partially or completely removed using a device called a resectoscope. The procedure takes between 10 and 30 minutes.
Once the hysteroscopy is completed, the anaesthetic is reversed, and you will wake up in the recovery area before being moved back to the day surgery unit to continue your recovery. The surgical team will see you to explain how the procedure went and what follow up is needed.
You will usually be discharged from hospital on the same day as the procedure. You will need someone to escort you home, and stay with you for 24 hours after.
You can ask your doctor for a sick note on the day of the procedure if you need one.
During the first 24 hours after a general anaesthetic you may feel more sleepy than usual and your judgement may be impaired. If you drink any alcohol, this might affect you more than normal. You should not drive or operate machinery during this time.
It is common to experience some discomfort in the form of period like cramps after the procedure, for which you can take simple pain relief (e.g. paracetamol or ibuprofen if you are usually okay with these). You may also experience light bleeding or watery vaginal discharge for a few days.
Some people are recommended to take some antibiotic tablets: we will explain if this applies to you.
To minimise any risk of infection following your hysteroscopy we recommend avoiding the following until any bleeding or discharge has stopped:
- Using tampons (use sanitary towels instead)
- Having sex
- Swimming
Signs of an infection include:
- Offensive vaginal discharge
- Severe or persistent abdominal pain
- Raised temperature
If you develop any signs of an infection, please contact your GP, or local emergency department if it is out of hours.
If a biopsy is taken or a polyp is removed, it will be sent to our laboratory where it will be tested for abnormalities. We will write to you and your GP with any histology results after approximately two weeks.
If you have any non-urgent questions or concerns, you can also contact the department who arranged the procedure for you. If your procedure was organised by the general gynaecology department, the email is uclh.
This procedure can also be performed without general anaesthetic in an outpatient hysteroscopy clinic. You can read more about this procedure in our leaflet entitled “Outpatient hysteroscopy”.
In some cases, an ultrasound and a biopsy taken without a camera, often referred to as a ‘Pipelle®’ biopsy, may provide adequate information about the lining of the uterus. This can usually be performed in clinic at the same appointment as your scan.
Another option is not to do anything. You may decide to avoid surgery and monitor your symptoms. If your symptoms persist or become worse, you might consider the procedure at a later date. You can discuss the potential risks of not doing anything with your doctor.
If you are running late or need to cancel the procedure on the day, you can call the department that is expecting you.
Surgical Admissions Unit: 0203 447 3184
Day Surgery Unit: 0203 447 0205
The following website from the Royal College of Anaesthetists may be helpful for information about general anaesthetic:
https://
If you have concerns about the care you received, you can contact The Patient Advice and Liaison service (PALS) which offers general support, information and assistance to patients, relatives and visitors.
Telephone: 020 3447 9975
Email: PALS
Address: PALS, Ground Floor Atrium, University College Hospital, 235 Euston Road, London, NW1 2BU
The Surgical Admissions Unit (Level 1) and the Day Surgery Unit (Level 2) are both in the main hospital.
Page last updated: 29 January 2025
Review due: 01 January 2027