Understanding Hysteroscopy procedure: A Complete Patient Guide

One of my patients said: “I heard hysteroscopy means surgery… will I need stitches?” Well not exactly! This is one of the most common concerns I hear when I suggest a hysteroscopy procedure. The truth is, this minimally invasive procedure involves no cuts or stitches—and for many women, it can be a game-changer in diagnosing and treating uterine issues.

Hysteroscopy is a precise, safe, and increasingly preferred procedure used to evaluate and treat conditions like abnormal uterine bleeding, infertility, fibroids, and polyps. Using a thin, lighted instrument called a hysteroscope, we can view the uterine cavity directly—and often treat the problem in the same sitting.

In this guide, I’ll walk you through what the hysteroscopy procedure involves. When it’s recommended, what to expect during recovery, and how it can significantly improve outcomes for women, especially those undergoing IVF or facing recurrent miscarriages. Whether you’ve been advised diagnostic or operative hysteroscopy, this article aims to answer all your questions with clarity and care.

Also Read:

• Essential Health Screenings Every Woman Should Start After 40
• Women’s Health After 40: What Changes and How to Stay Ahead
• Hysteroscopy in India: Finding the Right Care and What to Ask Your Doctor

What is Hysteroscopy?

Hysteroscopy is a minimally invasive procedure that allows direct visualization of the inside of the uterus. A small, illuminated tool called a hysteroscope allows me to check the uterus live on the screen and often carry out treatments at once. So, hysteroscopy for infertility is considered an effective “see and treat” method.

The hysteroscopy procedure can be done in two different ways:

• Diagnostic Hysteroscopy – Carried out when there are suspicions of bleeding too much, not being able to conceive or experiencing miscarriage several times.
• Operative Hysteroscopy – Sometimes done when treatment is recommended, including the removal of fibroids, polyps or adhesions inside the uterus.

What Is the Reason for a Hysteroscopy?

I normally suggest patients get a hysteroscopy before and after the results when they have the following kinds of problems:

• Abnormal Uterine Bleeding: Heavy periods, postmenopausal bleeding, or spotting that does not follow a pattern usually make doctors examine the uterine lining.
• Infertility Evaluation: If having a baby is a concern for you, hysteroscopy can assist in understanding and treating problems such as adhesions or polyps that may be preventing implantation.
• IVF Planning: A healthy uterus is important before attempting assisted reproduction.
• Remove Polyps or Fibroids: The growths can be seen during treatment and then removed immediately.
• Synechiae (Uterine Adhesions): Removal of scar tissue inside the uterus by surgery can be done to restore fertility.
• Intrauterine Devices: With the help of a hysteroscope, an intrauterine device can be removed without harm to the patient.
• Thickened Endometrium: When treating postmenopausal women, we check for any thickening because it could indicate cancer or hyperplasia.
• Recurrent Miscarriage or Retained Products of Conception: After an abortion or miscarriage, hysteroscopy can clean out the inner part of the uterus.
• Post-Caesarean Spotting or Isthmocele: Cesarean scar defects can lead to bleeding for some women, and this issue can be noticed and treated.
• Scar Ectopic Pregnancy: For cesarean scar pregnancy cases, doctors may use hysteroscopy both for diagnosis and to carry out treatment.

Steps to Take Before a Hysteroscopy

Going through proper preparation makes you more comfortable and allows the procedure to go smoothly.

• Timing: Usually, we schedule a hysteroscopy just after your period since the uterus lining is at its thinnest.
• Fasting: Patients may need to fast if they are given anaesthesia for any surgical procedure.
• Medication: At times, patients receive drugs to ease their discomfort and allow the cervix to open.
• Telling the Doctor the Symptoms: Always tell me if you or the patient has allergies, is taking any medication or might be pregnant.
• Obtaining Consent and Discussing Your Needs: I make sure to describe the advantages, disadvantages and other choices to you, as well as answer your questions.

What Happens During the Process?

This is the usual hysteroscopy procedure:

• Positioning: You will be placed in a position as if you are having a pelvic exam.
• Introducing the Hysteroscope: After placing a speculum to gently open the vaginal walls, a thin, lighted hysteroscope is carefully passed through the cervix into the uterus.”
• Filling the Uterus: To improve the doctor’s view, the uterus is filled with either fluid (saline) or gas.
• Illustration & Care: I check the condition of the lining inside the uterus. When planning operative hysteroscopy, these instruments can be introduced inside the uterus to complete the procedure.
• Duration: The procedure of diagnostic hysteroscopy usually takes around 10 to 15 minutes. Operative procedures usually take between 30 and 60 minutes, based on the complexity of the condition.
• Anaesthesia: Often, diagnostic hysteroscopy is performed without any type of anaesthesia or only with local anaesthesia. Some operations may need you to have general anaesthesia.

Hysteroscopy Recovery and Aftercare

Recovery after a hysteroscopy procedure is typically smooth and quick.

• After the Procedure: You could see some light cramps and light spotting or get watery discharge during the next 1–2 days.
• Activity: The majority of patients are able to perform regular activities and go to work within 24–48 hours.
• Sexual Activity: Most of the time, I suggest waiting for 3 to 5 days or until the bleeding stops.
• Pain Management: Most pain can be treated effectively with over-the-counter drugs.
• Follow-up: I set up another visit so we can talk about the findings and recommend the next course of action.

Please get in touch with me immediately whenever you have one of these symptoms:

• Heavy bleeding
• Intense pain in the abdomen
• Developing a fever or noticing a foul-smelling vaginal discharge
• These can indicate infection or unusual complications.

Side Effects and Risks of Doing a Hysteroscopy

The hysteroscopy procedure is often safe, but there are some potential hazards, as there are in any medical treatment:

Possible side effects:

• Light bleeding or spotting
• Mild cramping
• Temporary bloating

Rare complications:

• Uterine perforation
• Infection
• Fluid overload
• Damage to nearby organs

I make it a priority to reduce risk — I ensure everything is sterile, proper technique is used, and a patient evaluation is carried out ahead of the procedure.

What Hysteroscopy Can Do for Infertility?

Hysteroscopy is a major tool I use when assessing and managing infertility. Among other advantages, it does the following:

• Identifying uterine polyps, adhesions or septa that might stop a pregnancy.
• Creating an optimal uterine environment for embryo implantation.
• Helping increase IVF success rates by acting as a pre-IVF evaluation.
• Investigating causes of recurrent miscarriages, especially those linked to uterine shape.

Many women have become pregnant after their hysteroscopy for infertility solved their uterine challenges—naturally or through assisted reproduction.

What Is the Hysteroscopy Cost in India?

The hysteroscopy cost in India varies depending on the type of procedure, hospital facilities, city, and whether it’s diagnostic or operative. Typically, a diagnostic hysteroscopy costs between ₹15,000 and ₹30,000, whereas an operative hysteroscopy may range from ₹40,000 to ₹80,000.

Costs may also include anesthesia, specialist fees, or additional imaging tests. Many health insurance policies cover hysteroscopy if it’s medically indicated—especially for abnormal uterine bleeding, infertility, or suspected endometrial issues.

Always check with your doctor and insurance provider beforehand for accurate estimates and coverage eligibility.

Also Read:

• Understanding Hysteroscopy procedure: A Complete Patient Guide
• Hysteroscopy and Fertility: How It Improves IVF Success

FAQ: Hysteroscopy procedures

Q: Is Hysteroscopy painful?

Some cramping or mild discomfort may happen while you have a diagnostic hysteroscopy. Surgical procedures are usually done under anaesthesia.

Q: Can I get pregnant after a hysteroscopy?

Yes! Many women become pregnant naturally or through IVF after the procedure resolves uterine abnormalities.

Q: Do I need stitches after a hysteroscopy?

No stitches are needed. It’s a minimally invasive gynecology procedure done through the vagina and cervix.

Also Read:

• Glowing Through the Heat: Essential Summer Pregnancy Tips

Conclusion

The hysteroscopy procedure helps to accurately diagnose and manage many issues in a woman’s reproductive system. Whether it’s heavy bleeding, unexplained infertility, or IVF preparation, it offers precise diagnosis and treatment in one go.

Your reproductive health matters. Awareness is power, and asking the right questions is the first step. With empathy, clarity, and cutting-edge care, hysteroscopy can help you live a empowered, more confident life.

If you have any concerns, I’m here to help. Your well-being comes first.

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Dr. Madhu Goel
Senior Consultant Obstetrician and Gynaecologist
Director, Fortis La Femme

I am passionate about women’s health. With expertise in managing high-risk pregnancies, infertility, and various gynaecological issues, I strive to provide compassionate care. I am committed to ensuring the well-being of my patients. Follow me for insights and updates on women’s health.

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