Hysteroscopy

When you visit Dr. Ma Li's clinic for your hysteroscopy consultation, she will review your medical history and discuss the reason for the procedure, whether it’s to investigate symptoms like abnormal bleeding or fertility concerns, or to treat conditions such as polyps or fibroids. Dr. Ma Li will guide you through each step, answering your questions and ensuring you feel informed and at ease.

On the day of the procedure, you can expect a smooth and well-organised experience. The procedure is straightforward, which involves the following steps:

• Preparation – before the procedure begins, you may be given medication to dilate (open) your cervix, which helps the hysteroscope pass through more easily. You might also receive local anaesthesia, sedation, or general anaesthesia, depending on the complexity of the procedure and your individual comfort needs​. 
• Insertion of the hysteroscope – once you are positioned on the examination table with your legs in stirrups, your doctor gently inserts a speculum into your vagina to keep it open, much like during a Pap smear. The hysteroscope, a narrow tube with a camera and light at the tip, is then carefully guided through the cervix into the uterus​. 
• Expanding the uterus – to improve visibility inside the uterus, the doctor will fill your uterine cavity with a saline solution or carbon dioxide gas. This expands the uterine walls, helping the hysteroscope capture clear images of the uterine lining, fallopian tube openings, and any abnormalities present​. 
• Examination and treatment – as the hysteroscope transmits images to a monitor, your doctor carefully examines the interior of the uterus. If diagnostic, the procedure is used to identify conditions like fibroids, polyps, scar tissue, or malformations of the uterus. If an issue is found, operative hysteroscopy may also be performed, where small instruments can be inserted through the hysteroscope to remove growths, repair scar tissue, or take a biopsy for further testing​. 
• Completion – after the procedure, the hysteroscope is withdrawn, and the saline or gas used to expand the uterus flows out. You may experience light cramping or spotting for a few days, but most patients can return home the same day and resume normal activities shortly afterwards​. 

It is typically performed to diagnose or treat a range of uterine conditions that may be affecting your reproductive health or causing discomfort. Some of the common reasons why a hysteroscopy may be needed are:

• Abnormal uterine bleeding – to investigate the cause of heavy, prolonged, or irregular menstrual bleeding​. 
• Fibroids or polyps – to diagnose and remove growths within the uterus that may cause pain, bleeding, or fertility problems​. 
• Recurrent miscarriages – to examine the uterine cavity and determine if any abnormalities are contributing to repeated pregnancy loss​. 
• Infertility issues – to assess the uterine environment and check for blockages or structural issues that may be impacting fertility​. 
• Retained tissue – to remove placental or other tissue that may remain in the uterus after childbirth or miscarriage​. 

• Intrauterine device (IUD) issues – to locate and remove a misplaced or embedded IUD​. 

Although hysteroscopy is generally safe, as with any medical procedure, it carries some risks. These risks are rare, but it’s important to be aware of them:

• Infection – there is a small chance of developing an infection following the procedure​. 
• ​Heavy bleeding – some patients may experience more bleeding than expected, though this is uncommon​.
• Uterine or cervical injury – although rare, the insertion of the hysteroscope or surgical instruments may cause injury to the uterus, cervix, or nearby organs such as the bowel or bladder​. 
• Reaction to anaesthesia – if general anaesthesia or sedation is used, there may be a risk of adverse reactions in some cases.
• Intrauterine scarring – occasionally, scarring may develop in the uterus after the procedure, which could lead to fertility issues​.