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Gynaecology

Hysteroscopy

at Cadogan Clinic, London’s Leading Cosmetic Surgery Specialists. 

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Medically Reviewed October 2023, by Mr. Bryan Mayou (GMC: 1414396) - founder of the Cadogan Clinic and one of the world's leading plastic surgeons

What is a Hysteroscopy?

A hysteroscopy is a surgical procedure used to examine the inside of the uterus. The procedure can be effectively used to investigate many female health concerns, such as fertility issues or pelvic pain, make a diagnosis and treat the problem if appropriate, for example, removing polyps and fibroids.

A hysteroscopy procedure is carried out using a special piece of surgical equipment called a hysteroscope. This is a narrow telescope with a light and camera at the end. This camera will take images inside your uterus and there will be sent to a monitor, so the doctor can see what is going on inside your body.

The hysteroscope is passed into the uterus via the vagina and cervix. This means that the doctor will not have to make any surgical incisions as part of the hysteroscopy procedure.

A hysteroscopy can be carried out with or without a local or general anaesthetic and is carried out as a day case, meaning you can go home the same day as the procedure.

You can usually return to your everyday activities on the same day as your hysteroscopy procedure.

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When is a Hysteroscopy required?

A hysteroscopy procedure may be required to investigate, diagnose and possibly treat a number of issues:

Heavy periods, also known by the medical term menorrhagia, bring with them misery and pain for women. A hysteroscopy procedure can be carried out in order to find out what is causing this excessive bleeding. Fibroids, polycystic ovary syndrome, endometriosis and pelvic inflammatory disease may be the cause of your heavy periods.

Pelvic pain is the generic term for pain that is felt in the lower part of the abdomen. It may affect a small part or the pain may be spread around the whole pelvic area. Pelvic pain  may present as sudden and severe (acute pelvic pain) or the pain may last for six months or more (chronic pelvic pain). A hysteroscopy can be used to pinpoint what is causing pelvic pain, such as endometriosis or ovarian cysts, so appropriate treatment can be administered.

Recurrent miscarriage is the term used to describe three or more miscarriages in a row. Although it is not always known what causes recurrent miscarriages, a hysteroscopy can help to confirm or rule out cervical weakness or an abnormally-shaped uterus.

Fibroids are non-cancerous growths made up of muscle and fibrous tissue that develop in or around the uterus. Sometimes fibroids cause heavy or painful periods, abdominal or lower back pain, pain during sex, a frequent need to urinate and constipation. A hysteroscopy is used to diagnose fibroids.

Polyps are overgrown pieces of tissue protruding from the delicate skin of the cervix or the surface of the cervical canal. They are sometimes the cause of unexplained bleeding. They can be easily removed as part of a hysteroscopy procedure.

An intrauterine device, commonly referred to as an IUD, is a small T-shaped plastic and copper contraceptive device that's put into the uterus by a doctor or specialist nurse. Sometimes the IUD may become displaced, putting you at risk of pregnancy. A hysteroscopy can check if the IUD is still where it should be and if not, it can be put back in place during the procedure.

Who is suitable for hysteroscopy?

You are considered suitable for a hysteroscopy procedure if you are experiencing at least one of the following:

  • Heavy, painful periods
  • Unexplained bleeding (for example after sex or inbetween periods)
  • Unexplained pelvic pain
  • Recurrent miscarriages
  • Have previously suffered with fibroids or polyps
  • A missing or displaced intrauterine device (IUD)
  • Your doctor suspects you may have a medical condition such as endometriosis

A hysteroscopy can only be carried out on women who still have a uterus.


The cost of a Hysteroscopy

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What does the procedure involve?

A hysteroscopy procedure usually takes between five and 30 minutes, depending on whether you have any treatment during the procedure.

A hysteroscopy is usually carried out without an anaesthetic, but you may opt for a local anaesthetic. A general anaesthetic is used if the hysteroscopy involves a longer or more complex procedure, for example, fibroid removal.

You will be asked to undress from the waist down and lie down on a medical couch with your legs in supports. A sheet will be used to maintain your modesty and dignity.

Sometimes a surgical instrument called a speculum may be inserted into your vagina to hold it open before the hysteroscope, a long, thin tube containing a light source and camera, is passed into your uterus. You may experience some cramping or discomfort as the hysteroscope passes through your cervix.

Fluid is gently pumped into the uterus to give the doctor a clearer view of what is going on inside. The camera on the hysteroscopy will send images from inside your body to a monitor.

Sometimes a hysteroscopy biopsy (tissue sample) may be taken. If you are having treatment as part of your hysteroscopy procedure, fine surgical instruments can be passed along the hysteroscope in order to cut or burn away any abnormal tissue.


Specialists

We have invited a selection of the country's very best consultants to join us at the Cadogan Clinic so that you can be sure that whatever the nature of your treatment, you will be seeing one of the top practitioners in the country.

The Patient Journey. A breakdown of what you can expect on your journey with us

We are deeply invested in ensuring that every step of your surgical journey with us is as informative and reassuring to you as it can be. This article outlines what you can expect at each stage of the journey

The Patient Journey

Frequently Asked Questions

The hysteroscopy procedure is not considered to be painful, but of course this varies from person to person. Some women may experience discomfort or cramping when the hysteroscope passes through the cervix, while other women will not.

It is advisable to take over-the-counter painkillers an hour beforehand to help with discomfort after the procedure. Sometimes a local anaesthetic may be used to numb the cervix while a general anaesthetic is used for longer or more complicated procedures. Speak to your doctor if you have any concerns about pain relief and they will help to put your mind at rest.

The figure varies, from £900 to over £3,000, but you can expect to pay, on average, £2,196 for a private hysteroscopy UK. This depends on the type of hysteroscopy procedure and what else is included in the treatment package.

If you choose the Cadogan Clinic for your hysteroscopy in London, you will get:

  • Up to two 60 minute consultations with a leading specialist plastic surgeon at our award-winning premises in Chelsea
  • Your hysteroscopy at London’s leading specialist cosmetic surgery centre of excellence
  • 24/7 on-call nurse assistance
  • A Dedicated Patient Coordinator, as a personal point of contact through your journey with Cadogan
  • A preoperative medical assessment
  • Comprehensive aftercare courtesy of our specialist team of nurses

Most women feel ready to return to work the day after their hysteroscopy procedure. Some may even choose to return to work on the same day.

However, if you have had a treatment during your hysteroscopy, for example fibroid removal, or a general anaesthetic was used, then you may want to take a few days off to aid your recovery.

If you have had a general anaesthetic, you will not be allowed to drive for 24 hours afterwards.

If the doctor discovers anything during your hysteroscopy procedure, he will speak to you straight away.

If a tissue sample (hysteroscopy biopsy) is taken during your hysteroscopy, then this will be sent away for analysis. It may take several weeks for your hysteroscopy results to come back. These may be sent to the clinic or straight to your home address, so make sure you check with the doctor.

Most women are awake as hysteroscopy procedures are usually carried out without an anaesthetic or a local anaesthetic may be used to numb the cervix. However a general anaesthetic may be used if your hysteroscopy is likely to take a long time or if you are having treatment at the same time, such as fibroid or polyp removal.

A general anaesthetic puts you to sleep for the duration of the procedure. You will be unaware of your hysteroscopy and unable to feel any discomfort.

An operative hysteroscopy is a surgical procedure used to remove fibroids or polyps from the uterus. A D&C, or dilation and curettage, is a surgical procedure that involves widening (dilating) the cervix before removing tissue from the inner lining of the uterus using a special spoon-shaped surgical instrument. A D&C is commonly used to look for growths and to discover the cause of unexplained bleeding.

Unlike a hysteroscopy, a D&C is always performed under a general anaesthetic or sedation.

There are alternative diagnostic methods which can be performed alongside or independent of a hysteroscopy.

In a pelvic ultrasound, a small probe is introduced into the vagina and soundwaves are used to produce an image of the inside of the uterus. Another alternative diagnostic method is an endometrial biopsy. In this procedure, a narrow tube is passed through the cervix into the uterus and suction is used to remove a sample of the uterine lining.

However, it is worth bearing in mind that neither of these alternatives provide as much information as a hysteroscopy and can’t be used for treatment in the same way as a hysteroscopy procedure.

The risk of infections following a hysteroscopy procedure is low. However there is still a possibility that you may develop an infection after your hysteroscopy.

After having a hysteroscopy, you should avoid having sex for a week, or until any bleeding stops, as this will help to reduce the risk of infection. You should also avoid using tampons to absorb any post-hysteroscopy spotting or bleeding, as this can increase the risk of infection.

Yes, it is possible to get a hysteroscopy on the NHS. However the NHS has been, and continues to be, hit hard by the Covid-19 pandemic. High levels of staff sickness have had an impact on waiting times across the board. These waiting times vary from hospital to hospital. And any new waves of Covid-19 infections may result in this wait getting even longer. Because of this, many people choose to go to a private clinic for their hysteroscopy. At the Cadogan Clinic, there is no waiting list, so you can have the procedure promptly.

Hysteroscopy is generally considered to be a safe procedure. However there are some small risks attached. These include:

  • Excessive bleeding
  • Accidental damage to the uterus
  • Accidental damage to the cervix
  • Infection of the uterus
  • Feeling faint (if carried out without an anaesthetic)

The risk of complications from a hysteroscopy is higher for women who also have treatment during a hysteroscopy. A hysteroscopy is only carried out where the benefits outweigh the risks of the procedure.


What are the risks?

Complications are rare although, as with all surgery, possible. Your surgeon will discuss each of these risks comprehensively at your consultation. Read our FAQ section for more information.




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