Hysteroscopy is used to investigate:
- Heavy menstrual bleeding: Problems that cause heavy bleeding such as fibroids can been clearly seen on hysteroscopy
- Abnormal menstrual bleeding pattern: Hysteroscopy can identify problems known to cause irregular bleeding such as polyps.
- Bleeding after the menopause: Abnormalities of the womb lining, including cancer, which may cause postmenopausal bleeding can be diagnosed with hysteroscopy.
- Miscarriage and recurrent miscarriage: Fibroids, polyps and uterine septae that may cause miscarriage can be easily seen using hysteroscopy.
- Scant or absent periods: Scarring of the womb lining, for instance following a D&C, can be seen with hysteroscopy.
- Retained pregnancy products (e.g. after miscarriage): Hysteroscopy will give a clear answer regarding whether small remnants of a pregnancy have become stuck within the womb.
- Locate a lost intrauterine contraceptive device: A hysteroscopy will tell whether an intrauterine device is still located within the womb cavity if the threads of the device have become lost.
Hysteroscopy is used to treat:
- Fibroids: The submucous variety of fibroids is easily seen at the time of hysteroscopy and can be shaved away (or resected) using electrical energy. This operation is known as a Trans-Cervical Resection of Fibroid (or TCRF) and can be a very effective way of treating heavy periods. Submucous fibroids should be removed prior to IVF to improve the chances of the embryo implanting.
- Uterine septum: A uterine septum can be cut away (or resected) using hysteroscopy.
- Polyps: As for submucous fibroids, hysteroscopy can be used to shave away polyps. This is an effective treatment for some cases of irregular bleeding and bleeding after the menopause.
- Heavy periods: In women with heavy periods who have completed their family, shaving away the lining of the womb is a very effective way of reducing/stopping bleeding. This operation is called a Trans-Cervical Resection of Endometrium (or TCRE).
- Adhesions: Sometimes, the womb lining becomes scarred after operations like Dilatation & Curettage (or D&C), especially if performed to remove retained pregnancy products. Hysteroscopy can be used to break down these adhesions and improve the chance of embryo implantation and hence pregnancy.
- Lost IUDs: If the threads of an intrauterine contraceptive device (IUD) gets pulled up into the womb cavity, hysteroscopy can locate it in the womb and enable it to be removed.
- Retained pregnancy products: Sometimes pregnancy products and placental pieces remain in the womb after a miscarriage or a full-term delivery and may become very stuck to the womb lining. Hysteroscopy will allow these remnants to be separated from the lining and removed.