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Operations: Hysteroscopy with/without D and C including polpectomy with/without Mirena

Insurance code: Q1800

Introduction: This information is written by John Fairbank and is provided for the benefit of his patients. Additional information will be given during consultation in the clinic and during the pre-operative discussion. It is not appropriate for all surgeons’ individual practice or for all patients.

Purpose of operation: Hysteroscopy is a telescopic examination of the uterus to examine the endometrial cavity. Polyps can be removed and samples of tissue removed for pathological examination. A Mirena coil can be left behind to relieve heavy periods or contraception.

Description of procedure: The cervix is gently dilated and a narrow telescope inserted into the uterine cavity. This provides an excellent view of the endometrial cavity.

Anaesthetic: A light general anaesthetic is usually used although a diagnostic examination can sometimes be done under local anaesthetic.

Length of stay: These procedures are usually done as a day case.

Post-operative management: Sex and tampon usage are usually avoided until bleeding has stopped to reduce risks of infection.

Potential complications: These procedures are usually free of complications! Bleeding or infection can rarely occur. The rarest but potentially most important complication is that of uterine perforation when the hysteroscope passes through the uterine wall into the abdominal cavity. If there is suspicion of heavy bleeding the abdomen needs to be opened or inspected with a laparoscope through a small sub-umbilical incision. Usually however there is no heavy bleeding and a short course of anti-biotics and 24 hours observation are all that is required.

Post-operative consultation A post-operative consultation is not always required. If the tissue removed shows evidence of disease a post-operative visit is necessary to discuss further management. If a Mirena coil has been inserted you will be asked to complete a menstrual calendar for between six and eight weeks and bring this back with you. It should then be possible to predict if the Mirena is going to work well in your case.

Other considerations A hysteroscopy is a safe and simple way of checking the endometrial cavity and the best way of excluding endometrial pathology

Relevant websites

Information on hysteroscopy

Mirena Intra-uterine system