Hysteroscopic resection

Hysteroscopy is a technique to look directly inside the womb (uterus). A thin telescope called a hysteroscope is passed through the neck of the womb (cervix) into the cavity of the womb itself. Sterile water is put in via the hysteroscope to separate the walls of the womb and allow visualisation of the inside of the uterus. The hysteroscope is generally attached to a TV screen and photographs can be taken.

Hysteroscopic resection is a technique which is used as conservative treatment for women with menstrual symptoms. It is often performed instead of a hysterectomy (removal of the womb). Initially a narrow telescope (a hysteroscope) is introduced through the cervix to examine fully the cavity, then by passing electrical current through a small loop placed inside the hysteroscope the lining of the womb is removed (shaved-off).

Hysteroscopic resection also allows removal of fibroids that grow inside the uterus and that cause heavy menstrual bleeding. It also allows removal of uterine septum (a thick band of tissue inside the womb) that may cause miscarriages, and intrauterine adhesions (cling film inside the womb) that cause infertility, absence or very light periods and pelvic pain.

Sometimes it is necessary to take a course of tablets or to have one or more injections before the procedure. This approach helps to reduce the thickness of the lining of the womb and the diameter of fibroids and make the operation more successful. Hysteroscopic resection of either the endometrium (lining of the womb) or of fibroids is usually performed under a light general anaesthetic. The complications of such procedure are rare. They include perforation of the uterus which may lead to injury to the bowel and/or to the bladder, infection, bleeding and excessive fluid absorption. The whole procedure may take between 30 and 60 minutes. No overnight hospital stay is generally required. Normal activities can be resumed after 5-7 days.

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