Hysteroscopy, EUA and D&C

Summary

Hysteroscopy with examination under anaesthesia (EUA) and dilatation and curettage (D&C) is a short day procedure to look inside the womb and take a sample of its lining. It is the commonest minor gynaecological operation at our clinics, usually done to find the cause of abnormal bleeding.

• A thin telescope (hysteroscope) shows the inside of the womb on a screen; the cervix is gently widened and a small sample of lining is taken for the laboratory.
• Polyps, a coil (Mirena/IUD) insertion or removal, or a biopsy are often dealt with in the same sitting.
• Usually 10–20 minutes under a short general anaesthetic; home the same day.
• Cramps and light bleeding for a few days are normal; most women are back to normal life within a day or two.

This information supports discussion with your healthcare team. Reading, saving or printing it does not constitute consent to surgery.

About the operation

Three things usually happen in one short sitting. The examination under anaesthesia lets the surgeon assess the womb and pelvis thoroughly while you are relaxed under anaesthetic. The hysteroscopy passes a thin telescope through the cervix — no cuts anywhere — giving a clear view of the womb cavity to spot polyps, fibroids bulging into the cavity, or abnormal-looking lining. The D&C gently widens (dilates) the cervix and takes a sample (curettage) of the womb lining for the laboratory.

Where the hysteroscopy finds something treatable — most commonly a polyp — it is usually removed there and then. A hormonal coil (Mirena/LNG-IUS) can also be inserted at the end of the procedure if that is part of your plan, or an old coil with missing threads retrieved.

Why it is performed

• Bleeding after menopause — the most important reason: the lining must be examined to rule out serious disease
• Heavy, irregular or persistent bleeding not explained by scans or not responding to treatment
• A thickened lining or suspected polyp on ultrasound
• Coil problems — insertion where an outpatient fitting is not possible, or retrieval of a coil with missing threads

Benefits

• A tissue answer — the laboratory result either rules out serious disease or finds it early, when it is most treatable.
• See and treat — polyps and coil problems are usually sorted in the same sitting.
• Quick recovery — no cuts, home the same day, back to routine within days.

Alternatives

• Outpatient endometrial sampling — a thin sampling tube in clinic without anaesthetic; suitable for some women, but less complete and no polyp removal.
• Outpatient hysteroscopy — possible without general anaesthetic in selected cases.
• Scan surveillance — where the suspicion is low, repeat ultrasound is sometimes reasonable; your consultant will advise what is safe for you.

Preparing for surgery

You will have an ultrasound scan (abdominal and transvaginal) beforehand, and routine checks — blood pressure, blood tests where needed, and a review of your medicines and general health. Tell the team about all medicines you take — blood thinners may need adjusting. If there is any possibility of pregnancy, tell the team; the procedure is not done in pregnancy.

• Fasting: exact instructions are given; typically no food from 6 hours before, water up to 2 hours before.
• At home: arrange for someone to take you home; plan a quiet rest of the day.

The day of surgery

You are admitted on the day. The team confirms your identity and the plan, and you meet the anaesthetist and the surgeon — the time for last questions. You will be asked to sign the consent form, which records the procedure, its benefits and its risks as they apply to you — including what should be done if a polyp or other finding is discovered. You can still change your mind at this point.

During the operation

Under a short general anaesthetic, with your legs supported, the surgeon examines the pelvis, passes the hysteroscope through the cervix using fluid to open the cavity for a clear view, inspects the lining, then gently dilates the cervix and takes the curettage sample. Any polyp is removed, and a coil is inserted or retrieved if planned. The whole procedure usually takes 10–20 minutes. Everything removed is sent to the laboratory.

After the operation

• Cramps like period pain for a day or two — simple painkillers are enough.
• Bleeding — light bleeding or spotting for up to a week is normal.
• Going home — the same day, once you are comfortable, eating and passing urine.

Recovery at home

• Most women return to work and normal activity within 1–2 days.
• Use pads rather than tampons while there is bleeding; avoid sex until bleeding settles — usually about a week.
• Results: the laboratory report takes about 1–2 weeks. Attend your follow-up — the result is the whole point of the procedure, and your next steps depend on it.

Risks and complications

This is one of the safest gynaecological procedures, but no operation is risk-free. Figures below are averages from published UK guidance; your own risk will be discussed with you.

Expected, temporary effects

• Cramping and light bleeding for a few days

Complications

• Infection of the womb or urine — usually settles with antibiotics (uncommon).
• Perforation — a small hole in the womb wall made by an instrument; usually heals on its own, occasionally needs a laparoscopy to check (rare, about 1 in 1000 for diagnostic procedures).
• Bleeding heavy enough to need treatment (rare).
• Cervical injury during dilatation (rare).
• A missed abnormality — no test is perfect; persistent symptoms should always be re-reported even after a normal result.
• Anaesthetic risks — serious complications of a short general anaesthetic are rare in otherwise healthy women.

When to seek help

After you go home, seek medical advice the same day if you notice:

• Heavy vaginal bleeding — bright red, or soaking a pad in an hour
• Fever (38 °C or higher) or feeling increasingly unwell
• Worsening abdominal pain not controlled by your painkillers
• An offensive-smelling vaginal discharge
• A painful, swollen or red leg

Preparing for your consent discussion

Consent is a conversation, not a signature. Before agreeing you should feel you understand why this procedure is recommended for you, what the realistic alternatives are, and which risks matter most in your case. Print this checklist and bring it to your consultation.

Sources and review

This page was drafted against the published guidance below. Each reference was live when checked; dates will be confirmed at clinical review.

1. Royal College of Obstetricians and Gynaecologists. Hysteroscopy — patient information. Available from: https://www.rcog.org.uk/for-the-public/browse-our-patient-information/ [last checked 12 August 2026].
2. National Institute for Health and Care Excellence. Heavy menstrual bleeding: assessment and management. NICE guideline NG88. Available from: https://www.nice.org.uk/guidance/ng88 [last checked 12 August 2026].
3. National Health Service (UK). Hysteroscopy. Available from: https://www.nhs.uk/tests-and-treatments/hysteroscopy/ [last checked 12 August 2026].