Diagnostic and Operative Hysteroscopy
Direct visualisation and treatment of the uterine cavity through a thin telescope passed through the cervix – minimally invasive and highly effective for many intra-uterine conditions.
Hysteroscopic interventions
- Endometrial polyps
- Submucosal fibroids
- Uterine septum
- Asherman syndrome (intrauterine adhesions)
- Endometrial sampling
- Lost IUCDs
- Caesarean scar niche
How it is performed
Office hysteroscopy under local anaesthesia or sedation. Operative procedures under general anaesthesia. Saline distension. Specialised instruments through working channels for tissue removal.
After hysteroscopy
Same-day discharge. Minor cramping for 24-48 hours. Light spotting for a few days. Return to normal activity within 24 hours. Pregnancy attempts can resume after first menstrual cycle in most cases.
Is this page relevant to you?
This page is for women advised to have a hysteroscopy — for abnormal or heavy bleeding, a suspected polyp or fibroid inside the uterine cavity, recurrent miscarriage or repeated IVF failure, suspected scar tissue, or as part of a fertility workup — who want to understand what it involves and why.
Diagnostic and operative hysteroscopy
Hysteroscopy passes a fine telescope through the cervix to inspect the uterine cavity — with no abdominal incision. A diagnostic hysteroscopy looks; an operative hysteroscopy treats. Where it is safe and appropriate, we follow a “see-and-treat” approach, dealing with the problem in the same sitting rather than asking you to return for a second procedure.
Conditions hysteroscopy can address
Hysteroscopy is used to remove endometrial polyps and submucosal fibroids, to divide intrauterine adhesions (Asherman syndrome) or a uterine septum, and to investigate abnormal bleeding or a cavity abnormality seen on imaging. Treating these can improve bleeding and, in selected cases, fertility outcomes.
Recovery after hysteroscopy
Most hysteroscopies are day-care procedures. Light cramping and spotting for a day or two are normal, and most women return to usual activity quickly. We explain what to expect and when to make contact.
Used selectively, not routinely
Hysteroscopy is most valuable when imaging suggests a cavity cause; it is used selectively rather than as a routine test. We will explain clearly why it is — or is not — the right next step for your situation.
Guidelines we follow
- ESGE guidance on diagnostic and operative hysteroscopy
- RCOG guidance on endometrial polyps and abnormal bleeding
- AAGL standards for hysteroscopic surgery
Hysteroscopy
| Type | Use |
|---|---|
| Diagnostic | Inspect the uterine cavity |
| Operative | Polyps, fibroids, septum, adhesions |
Frequently asked
Dr Patel performs advanced minimal-access (laparoscopic and hysteroscopic) surgery at Balaji Horizon with a precision, organ- and fertility-sparing philosophy — operating when it is clearly indicated, and offering conservative options when it is not.
Minimal-access, organ-sparing surgery and evidence-based gynaecology — with a clear, honest plan built around your priorities.
Book a consultationAbout diagnostic and operative hysteroscopy.
Hysteroscopy is the direct visualisation of the uterine cavity. We use it to investigate abnormal uterine bleeding, recurrent miscarriage, post-IVF implantation failure, and to remove polyps, submucous fibroids, septa and adhesions.
Risks, recovery & when hysteroscopy is the right step
Hysteroscopy lets us look inside the uterine cavity and treat problems — polyps, a uterine septum, submucous fibroids, adhesions or retained tissue — through the natural passage of the cervix, with no abdominal incision. For fertility, correcting these can improve implantation and reduce miscarriage in selected women.
Possible risks
Hysteroscopy is generally very safe as a day-care procedure. Uncommon risks include uterine perforation, infection, and — during longer operative cases using fluid to distend the cavity — absorption of that fluid, which is monitored carefully to avoid dilutional electrolyte changes. Extensive resection carries a small risk of later intrauterine adhesions, which we minimise with careful technique.
Recovery
Most women go home the same day, with light spotting and mild cramping for a few days and a return to normal activity within one to two days. We explain warning signs to watch for before you leave.
When it may not be advised, and alternatives
Hysteroscopy is deferred in active pelvic infection or when a desired intrauterine pregnancy is possible. For purely diagnostic questions, saline-infusion sonography or an endometrial biopsy may answer the question without operative hysteroscopy — we choose the least invasive test that gives a reliable answer.
Could a hysteroscopy help? — a quick orientation
A quick guide to where hysteroscopy fits. Educational only — not a diagnosis.
This interactive guide is educational and does not replace a clinical assessment or imaging review. It cannot diagnose your condition. Please discuss your situation with Dr. Priyadatt Patel at Balaji Horizon Women’s Hospital.
Office (“see-and-treat”) hysteroscopy: assess and treat in one visit
Much of modern hysteroscopy is now performed in an outpatient, “see-and-treat” setting, using a fine telescope and gentle normal-saline distension — frequently without formal anaesthesia. For many women this means a single visit in which the uterine cavity is inspected and a small polyp or adhesion can be treated in the same sitting. Reviewed evidence, including the American College of Obstetricians and Gynecologists (ACOG) 2020 guidance, associates office-based hysteroscopy with higher patient satisfaction and faster recovery than the equivalent procedure under general anaesthesia. We still choose the office or the day-care theatre individually: a larger fibroid, extensive adhesions, a narrow cervix, or simply a woman’s comfort may make a planned theatre procedure the safer, kinder choice.
When in your cycle hysteroscopy is best timed
In women who are still menstruating, diagnostic hysteroscopy gives the clearest picture in the early proliferative (follicular) phase — the week or so just after a period ends, when the lining is thin. Pregnancy is reasonably excluded beforehand. If you are actively trying to conceive, we generally schedule the procedure before mid-cycle to respect the developing egg or embryo. Routine softening of the cervix is not needed for most women, but may be considered where the cervix is likely to be tight or the procedure more uncomfortable (ACOG, 2020).
Distension media and fluid safety
To see inside the uterus, the cavity is gently expanded with fluid. For diagnostic and most modern bipolar operative hysteroscopy, isotonic normal saline is used because it is safe and readily available. During longer operative procedures the volume of fluid absorbed is measured continuously and the operation is stopped well within defined safe limits — following the AAGL guidelines for managing hysteroscopic distending media (2013) and the BSGE/ESGE fluid-management guideline (2016). These safeguards are one reason hysteroscopy has an excellent safety record in experienced hands.
Protecting the cavity and your future fertility
Because hysteroscopy works through the natural passage of the cervix, it does not cut or scar the outside of the uterus — it is inherently uterus-sparing. Careful, tissue-respecting technique also matters for what is left behind: over-aggressive surgery inside the cavity can itself cause intrauterine adhesions (Asherman syndrome). Where adhesions or a uterine septum are treated, we follow AAGL/ESGE adhesion-prevention principles and, when appropriate, plan a short follow-up check so the cavity heals open. This fertility-protective mindset sits at the centre of how we approach every intrauterine procedure — see our wider approach to fertility preservation.
Common reasons we recommend hysteroscopy
Hysteroscopy is used selectively — only when it will change a decision or treat a specific problem, never as a routine screening test. The commonest reasons include a submucosal fibroid or an endometrial polyp distorting the cavity, heavy menstrual bleeding or other menstrual disorders that need the lining assessed, abnormal or post-menopausal bleeding needing a targeted biopsy, retained tissue, or a cavity abnormality found before IVF. It also complements advanced laparoscopic surgery when both the inside and the outside of the uterus need attention.
Guidelines and evidence we follow
- ACOG Committee Opinion No. 800: The Use of Hysteroscopy for the Diagnosis and Treatment of Intrauterine Pathology. Obstet Gynecol. 2020;135(3):e138–e148.
- AAGL Practice Report: Practice Guidelines for the Management of Hysteroscopic Distending Media. J Minim Invasive Gynecol. 2013;20(2):137–148.
- Umranikar S, et al. BSGE/ESGE guideline on the management of fluid distension media in operative hysteroscopy. Gynecol Surg. 2016;13:289–303.
- AAGL/ESGE: Practice Guidelines on Intrauterine Adhesions. J Minim Invasive Gynecol. 2017;24(5):695–705.
Reviewed by Dr. Priyadatt Patel, MBBS, MS (Obstetrics & Gynaecology) — Senior Gynecologist · Advanced Laparoscopic Surgeon · IVF and Endometriosis Programme Lead & Advanced Laparoscopic Surgeon. Educational information only; it does not replace an individual consultation. Last reviewed 1 July 2026.
Dr. Priyadatt Patel
Senior Gynecologist · Advanced Laparoscopic Surgeon · IVF and Endometriosis Programme Lead
MS OBGyn · Pregnancy Care · Advanced Gynaecological Ultrasound · Fertility Preservation
ESHRE / ESGE / AAGL / ASRM guideline-aligned practice. 3D Karl Storz precision technique. Fertility-preservation-first philosophy. Evidence-based decisions, honest counselling, long-term outcomes orientation.
Science City Road, Ahmedabad 380060
Mon–Sat 11:00–20:00 · +91 97234 31544
Naranpura, Ahmedabad
Mon–Sat 08:30–10:30 · +91 70460 02566
