Uzm. Dr. Ertan Özen
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Gynaecological Procedures
Hysteroscopy
What a hysteroscopy is, what a camera passed through the cervix can show that a scan cannot, how diagnostic and operative hysteroscopy differ, whether it hurts and how pain is managed, whether it is useful before IVF, approximate costs in Turkey against the UK, US and Germany, preparation, recovery, risks and how to check a clinic.
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Prof. Dr. Zehra Neşe Kavak
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What is hysteroscopy and what can it show that a scan cannot?
Hysteroscopy is a procedure in which a thin telescope with a light and camera, the hysteroscope, is passed through the vagina and cervix so that the doctor can look at the inside of the womb on a screen. Saline or another clear fluid is run in gently to open the cavity. Ultrasound shows the womb from outside its lining; hysteroscopy lets the doctor see the lining itself, take a targeted biopsy and, with the right instruments, treat a problem at the same time. Hospitals in Turkey offer hysteroscopy as both a clinic test and a theatre procedure.
This guide explains why it is done, how the diagnostic and operative versions differ, whether it hurts, what the evidence says about doing it before IVF, what it costs in Turkey compared with the UK, US and Germany, and how recovery works. For the full list of procedures see our gynaecology treatments in Turkey.
Why is a hysteroscopy done?
The usual reasons are bleeding that is heavy, irregular or comes after the menopause; an unclear finding on ultrasound such as a thickened lining or a suspected polyp or fibroid; repeated miscarriage; difficulty conceiving; and a suspected scar or septum inside the womb. It can also be used to find a lost coil, to take a biopsy of the lining or to check the womb before or after other surgery. The NHS advises that postmenopausal bleeding should always be investigated, and hysteroscopy with a biopsy is a standard part of that work-up.
Diagnostic or operative hysteroscopy: what is the difference?
Diagnostic hysteroscopy looks and, if needed, takes a biopsy. Operative hysteroscopy treats a problem in the same sitting: removing a polyp (see hysteroscopic polypectomy), a fibroid that bulges into the cavity (hysteroscopic myomectomy), scar tissue, or a septum (hysteroscopic septoplasty). A narrow scope of about 3 to 5 mm can do both in a clinic without a general anaesthetic (an outpatient or "see and treat" approach); wider instruments need theatre, sedation or general anaesthesia. Many surgeons start with a diagnostic look and treat in the same visit when the finding is simple, which spares a second procedure.
Does hysteroscopy hurt?
Most women feel period-like cramps, pressure or a pulling feeling for a few minutes, and a minority find it painful, especially with a tight cervix, after the menopause or when anxious. Pain is reduced by using a narrow scope, a vaginoscopic approach that avoids the speculum and clamp on the cervix, warm saline, and simple painkillers taken before. If you prefer, sedation or a short general anaesthetic can be arranged, and this is the usual choice for operative work. Tell the team about previous difficult examinations or a history of fainting.
Hysteroscopy cost in Turkey compared with the UK, US and Germany
The figures are approximate ranges for a diagnostic hysteroscopy with the consultation, not hospital quotes. Operative hysteroscopy costs more and is priced by procedure. Each hospital confirms its price in writing.
| Country | Approximate cost range (diagnostic) |
|---|---|
| Turkey | €250 – €1,200 |
| United Kingdom | €600 – €2,000 |
| United States | €1,000 – €4,000 |
| Germany | €500 – €1,800 |
What changes the price: clinic or theatre setting, local, sedation or general anaesthesia, whether a biopsy and laboratory report are included, whether a treatment is carried out at the same time, and whether the visit also includes a pelvic ultrasound. A package normally includes the consultation, the procedure, any anaesthesia, histology and a follow-up; ask for the list in writing.
Hysteroscopy, ultrasound or HSG: which test shows what?
These tests answer different questions and are often combined.
| Test | Suited to | Typical limits |
|---|---|---|
| Hysteroscopy | Direct view of the lining; biopsy; treating polyps, scar tissue, septum | Does not show the outside of the womb or the ovaries |
| Pelvic ultrasound, including 3D | Womb shape, fibroids, ovaries, lining thickness | Can miss small polyps and adhesions |
| Hysterosalpingogram (HSG, X-ray with dye) | Whether the tubes are open | Poor at telling a septum from a bicornuate womb; radiation |
Hysteroscopy is often chosen when the ultrasound has raised a question that needs a direct look or a biopsy.
A normal hysteroscopy is useful information in itself: it rules out a structural cause of bleeding or failed pregnancy and lets your doctor move on to hormonal, genetic or other explanations without guessing. Keep the photographs and the written report, because a fertility team or a gynaecologist at home will want to see them.
Is hysteroscopy useful before IVF?
Here the evidence is mixed. If a scan or earlier cycle suggests a polyp, fibroid, septum or scarring in the cavity, removing it is widely accepted. For routine hysteroscopy in every woman before a first IVF cycle with a normal scan, large randomised trials have not shown a clear improvement in live birth rates, and European fertility guidelines do not recommend it for everyone. For women with repeated failed transfers or a suspicious scan, a hysteroscopy is more often offered. Ask your fertility doctor what question the hysteroscopy is meant to answer.
How to prepare and what happens on the day
The best time is just after a period, when the lining is thin and the view is clear. Pregnancy is excluded by a test beforehand. You may be asked to take a painkiller an hour earlier and to eat lightly if sedation is planned; fasting is needed for general anaesthesia. During the procedure you lie as for a smear test, the scope is inserted, the surgeon examines the cervical canal and the cavity, looks at both tubal openings, and takes any biopsy. A diagnostic look takes 5 to 15 minutes, operative work 15 to 45. Some units let you watch the screen. You normally leave the same day with a written report and photographs of the cavity.
Hysteroscopy recovery: what to expect
Cramps ease within hours and light bleeding or watery discharge can last a few days to two weeks. Most women return to normal activities the next day; after sedation or general anaesthesia plan for a rest day. Avoid tampons, sex, swimming and baths for about a week, or longer after operative work, as your surgeon advises. Contact the clinic for a fever, heavy bleeding that soaks a pad an hour, worsening pelvic pain or foul-smelling discharge. If a biopsy was taken, the result arrives within about one to two weeks. For a trip, one to two nights is enough for a diagnostic hysteroscopy; two to four nights for operative treatment.
Risks and complications of hysteroscopy
Diagnostic hysteroscopy is a low-risk procedure, but complications can happen. Fainting during the test (vasovagal reaction), cramps and light bleeding are the common effects. Infection, heavier bleeding, injury to the cervix and perforation of the womb wall are uncommon, and fluid overload can occur when more fluid than expected is absorbed during longer operations. The risk is higher with operative work, a tight or scarred cervix, and after the menopause. Pregnancy and active pelvic infection are reasons to postpone. The RCOG and NHS patient information describe these risks and what to do if you have symptoms at home.
How to choose a clinic, and what to ask
Look for a gynaecologist who does hysteroscopy regularly, a licensed hospital with a pathology laboratory for any biopsy, and a clear plan for who reads and explains your result once you are home. Red flags include a quote without a stated technique, a refusal to share the report and photographs, pressure to add unneeded tests and no named doctor. Read how our process works and send your scan reports through the free quote page.
Questions worth asking:
- Will this be a diagnostic look only, or can you treat a finding at the same sitting?
- Will I be awake, sedated or under general anaesthesia?
- Is a biopsy and laboratory report included, and how will I get the result?
- Will I receive photographs of the cavity and a written report?
- How many nights should I plan, and who do I call after I fly home?
Hospitals with Gynaecology in Turkey
Frequently asked questions
Hysteroscopy is a procedure in which a thin camera is passed through the cervix to look at the inside of the womb. It can include a biopsy or treatment of polyps, scar tissue, fibroids or a septum.
Most women feel period-like cramps for a few minutes, and some find it painful. A narrow scope, warm saline, painkillers beforehand or sedation reduce discomfort. A general anaesthetic can be arranged if you prefer.
Approximate ranges for a diagnostic hysteroscopy are €250 to €1,200 in Turkey against about €600 to €2,000 in the UK. Operative treatment, anaesthesia and biopsy raise the price; the hospital confirms it in writing.
It can show polyps, fibroids bulging into the cavity, scar tissue, a uterine septum, a lost coil or lining changes that need a biopsy. It does not show the ovaries or the outside of the womb.
A diagnostic look takes about 5 to 15 minutes. Operative hysteroscopy, such as removing a polyp or fibroid, usually takes 15 to 45 minutes depending on what is found.
Most women resume normal activities the next day. Light bleeding or discharge can last a few days to two weeks, and tampons, sex and swimming are usually avoided for about a week.
It is useful when a scan or earlier cycles suggest a problem in the cavity. Trials have not shown clear benefit from routine hysteroscopy for every woman with a normal scan before a first cycle.
It is generally safe. Rare complications include infection, bleeding, injury to the cervix and perforation of the womb wall. Risks are higher with operative work or a scarred cervix.
Ultrasound images the womb through its wall, while hysteroscopy shows the lining directly and allows a biopsy or treatment. Doctors often use both, and hysteroscopy follows an unclear scan.
One to two nights is enough for a diagnostic hysteroscopy, and two to four nights for operative treatment, so that the surgeon can check you before the flight and discuss any result.
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