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Hysteroscopy and endometrial ablation

Hysteroscopy

Hysteroscopy involves gently inserting a small camera through the cervix into the cavity of the uterus to examine it for any abnormalities. This operation is performed as a short day procedure under a light general anaesthetic.

A curette, or “D and C” will also usually be performed after a hysteroscopy, to take a sample of the lining of the endometrium to send to pathology to check for any abnormal cells. Any polyps or other growths seen in the uterus will also be removed and sent for pathology also.

Reasons for hysteroscopy and D+C include:

  • Abnormal bleeding from the uterus (heavy or prolonged periods or irregular periods with bleeding between the periods).
  • Uterine bleeding after the menopause.
  • Pelvic pain and painful periods.
  • Infertility.
  • Recurrent miscarriages.
  • Suspicion of adhesions in the uterus.

Using the hysteroscope, certain operations can also be performed within the cavity of the uterus to treat certain uterine problems, including:

  • Removal of fibroids (non-cancerous growths of the muscle wall of the uterus) which are within the cavity of the uterus.
  • Removal of polyps (usually non-cancerous growths of the lining of the uterus).
  • Remove adhesions in the uterus.
  • Correct any defects in the cavity of the uterus like a uterine septum.
  • Removal of a retained Mirena or other IUD.
  • A common procedure performed in conjunction with a hysteroscopy and D+C is an Endometrial ablation.

Endometrial ablation

This is a procedure to treat heavy or irregular periods when a woman is sure she has finished her family and wants no more children.

Effectively it involves burning away the lining of the uterus (endometrium) causing the inside of the uterus to scar over. This means when it is time for a period, there is no endometrial lining to shed away and bleed as it has been destroyed by the ablation procedure.

After this, pregnancy must not occur and so often some sort of permanent contraception procedure will be required also to ensure pregnancy will not occur.

The ablation procedure takes about 20 minutes to perform. Is it normal afterwards to experience some pink discharge which can occur for up to 4-5 weeks, and also some cramping pain after the procedure for a few days. Any offensive discharge or fevers or feeling unwell should be reported to Dr Friebe as this can indicate an infection has occurred.

Overall, the procedure has a 90% chance of fixing the period problem. Most women will have no further bleeding at all, some will still have periods but they will be significantly lighter, and a very small percentage will see no major benefit and may need to go on to have a hysterectomy for definitive management of their period problems.

Related Information

Heavy Periods