Hysteroscopy In Singapore: What to Know Before You Decide

If your gynaecologist has recommended a hysteroscopy, you may wonder why you need it, what happens during the procedure, and how much it will cost in Singapore.

This article explains why hysteroscopy may be recommended, what to expect, and the recovery, possible risks, costs, and insurance considerations.

What is a hysteroscopy?

A hysteroscopy is a procedure that allows your gynaecologist to observe inside your uterus. Your gynaecologist uses a hysteroscope – a thin tube with a light and a small camera – which is passed through your vagina and cervix into your uterus so they can examine its inner lining.

Hysteroscopy can be used to investigate and treat certain conditions inside the womb. Your doctor can perform a this procedure in an outpatient setting, although a more complex procedure may take place in a hospital operating theatre.

Why your gynaecologist may have suggested one

Your gynaecologist may have suggested a hysteroscopy to find out why you’re having heavy or irregular periods, bleeding between periods, or bleeding after menopause. The procedure allows them to assess for conditions that could explain the bleeding.

Other reasons your gynaecologist may recommend it include:

• Investigating suspected polyps or submucosal fibroids: A hysteroscopy can help locate growths that project into the uterine cavity. 
• Assessing an unusual scan finding: If an ultrasound shows a possible polyp, growth or other abnormality inside the uterine cavity, your gynaecologist may recommend further assessment.  
• Evaluating the uterine cavity during fertility investigations: Your gynaecologist may look for abnormalities such as scar tissue or a uterine septum (a partition present from birth that divides the uterine cavity). 
• Locating or removing an intrauterine device (IUD): Hysteroscopy may be used if the IUD’s threads cannot be seen or it is difficult to remove.
• Analysing possible retained pregnancy tissue: In selected cases, your doctor may use it to assess and remove tissue remaining in the uterus after a pregnancy. 

What are the types of hysteroscopy?

There are two main types of hysteroscopy: diagnostic and operative. The difference is their purpose – diagnostic hysteroscopy is for identifying a condition, while operative hysteroscopy’s purpose is to treat the condition. 

Diagnostic hysteroscopy 

A diagnostic hysteroscopy allows your gynaecologist to inspect the lining and cavity of your womb directly. It can help identify conditions that project into the uterine cavity, scar tissue or abnormalities in the cavity’s shape.

If needed, your gynaecologist may take a small sample (biopsy) of the womb lining, called an endometrial biopsy, for laboratory testing. 

Operative hysteroscopy

An operative hysteroscopy allows your gynaecologist to treat certain abnormalities inside your womb using fine surgical instruments passed through the hysteroscope. Depending on the findings, this may involve removing a polyp, removing a fibroid, or dividing bands of scar tissue called adhesions.

If your doctor finds a specific abnormality during the diagnostic examination, treatment may be possible at the same visit. This is also known as a “see-and-treat” approach and can avoid a separate procedure. However, same-day treatment is not always appropriate, and your doctor should discuss any proposed treatment with you and obtain your consent beforehand.

If you have been recommended a hysteroscopy and want to understand your options first, WhatsApp our Care Team. Tell us what you have been told and any scan or test reports you have, and we will send you one to three gynaecologists matched to your situation, each with a reason. You choose who to see, and we arrange the appointment.

What the day of the procedure looks like

Knowing what happens before, during and after a hysteroscopy can help you feel more prepared for the day of the procedure. 

Before the procedure

Your gynaecologist will review your medical history, explain what they plan to do and discuss your pain relief options. Before signing the consent form, you can ask whether the procedure will include a biopsy or treatment.

To prepare for your appointment:

• Tell your care team about your medicines, supplements and allergies. Your doctor will advise whether any medicines need to be adjusted, but do not stop them on your own.
• Let them know if you could be pregnant. Hysteroscopy should not be performed during pregnancy, and you may be asked to take a pregnancy test on the day.
• Discuss pain relief in advance. Depending on your needs and what the facility offers, options may include oral painkillers, local anaesthesia, intravenous sedation, or general anaesthesia.
• Follow your clinic’s eating and drinking instructions. If sedation or general anaesthesia is planned, you may need to fast beforehand. Arrange for someone to collect you afterwards, as you must not drive yourself home.

Wear comfortable clothes that are easy to remove. On arrival, you may be asked to change into a gown and empty your bladder before the procedure.

During the procedure

You will lie on an examination table, and your gynaecologist will pass the hysteroscope through your vagina and cervix into your womb. A speculum may be used, and your cervix may need to be gently widened, depending on the technique and procedure planned.

Your doctor will use sterile salt water, called saline solution, that flows through the hysteroscope to gently expand the uterine cavity. This gives your doctor a clearer view of the uterine lining, with images from the camera displayed on a monitor. If you’re awake, you may be able to watch the screen.

If you have agreed to a biopsy or treatment, your doctor may take a tissue sample or use fine instruments to remove a polyp or suitable fibroid during the same procedure. 

If you’re awake during the procedure, you may experience cramping, nausea, or faintness. You can tell the team how you’re feeling during your hysteroscopy.

After the procedure

You will have time to rest before going home. If you’ve had anaesthesia, the team will monitor you until you’re alert and well enough to leave. You may go home the same day, although an overnight stay may occasionally be needed. 

Period-like cramps and light bleeding or spotting may occur after the procedure. These symptoms often settle within a few days, although bleeding may last up to about a week. 

Use sanitary pads rather than tampons, and avoid sexual intercourse and exercise until the pain and bleeding have stopped, unless your doctor gives you different instructions.

If you’re considering a hysteroscopy and want help deciding what to do next, WhatsApp our Care Team. We can help match you with a suitable gynaecologist, arrange an appointment and support you with the next steps. 

What are the possible risks and complications?

Hysteroscopy is generally safe, and serious complications are uncommon. However, your risk depends on whether you’re having a diagnostic examination or treatment, such as removal of a polyp or fibroid. Complications are more likely during operative hysteroscopy than during a diagnostic examination alone.

Possible complications include:

• Infection: A small number of patients develop an infection after hysteroscopy. Possible symptoms include fever, worsening lower abdominal pain or foul-smelling vaginal discharge.
• Heavy bleeding: Excessive bleeding is not common and may require further treatment or another procedure to control it.
• Injury to the cervix or womb: Instruments can occasionally damage the cervix or make a small hole in the womb wall, known as uterine perforation. RCOG reports that this occurs in fewer than 1 in 200 diagnostic hysteroscopy procedures, with a slightly higher risk when a polyp or fibroid is removed. You may need to stay in hospital overnight for observation. 
• Injury to nearby organs: Rarely, a perforation can also injure nearby structures, such as the bowel or bladder, and further surgery may be necessary.
• Problems caused by the fluid used during the procedure: The fluid used to expand the womb can rarely be absorbed in excessive amounts. The surgical team monitors the amount of fluid used to reduce this risk, particularly during operative hysteroscopy. 
• Scar tissue inside the womb: Adhesions can form after operative hysteroscopy. This is a potential complication of treatment rather than an expected outcome of a diagnostic examination.
• Side effects from anaesthesia: You may feel drowsy or nauseated afterwards. Serious reactions are uncommon but can include breathing problems or a severe allergic reaction. 

When to call a doctor after a hysteroscopy

Contact your gynaecologist or the hospital where you had the procedure if you develop:

• Bleeding that is heavy or getting worse, especially if it soaks through a sanitary pad within an hour or you pass large clots.
• Severe or worsening lower abdominal pain that does not improve with the pain relief recommended by your doctor.
• Fever, chills or foul-smelling vaginal discharge. 
• Increasing abdominal swelling, faintness, or feeling very unwell.

Seek emergency care immediately for chest pain, severe difficulty breathing, coughing up blood or loss of consciousness. New pain, redness, or swelling in one leg also needs urgent medical assessment. 

Costs and insurance for a hysteroscopy in Singapore

The cost of a hysteroscopy in Singapore depends on whether you attend a public or private hospital, qualify for subsidies, need general anaesthesia, and have an examination alone or an additional procedure. 

Rather than one overall price range, the Ministry of Health (MOH) publishes bill information by procedure under the Table of Surgical Procedures (TOSP).

The following figures give an indication of day-surgery costs of common diagnostic hysteroscopy procedures published by MOH:

These are MOH bill ranges, not guaranteed prices or personal quotations. They may vary according to your hospital, subsidy status, anaesthesia, doctor’s fees, pathology, medicines and whether additional treatment is performed. MOH does not publish bill ranges for every setting. Where private day-surgery data is unavailable for a procedure code, hospitals can provide a quotation on request.

Depending on your eligibility and the procedure planned, you may be able to use insurance from:

• MediSave to pay part of eligible day-surgery or hospitalisation expenses, subject to withdrawal limits. MediSave uses your healthcare savings; it does not reduce the hospital’s charges.
• MediShield Life to cover part of a claimable hospital or day-surgery bill, subject to claim limits, deductibles and co-insurance. Its benefits are designed around subsidised public-hospital care, and claims for private or unsubsidised care are pro-rated.
• An Integrated Shield Plan, if you have one, which combines MediShield Life with additional private insurance coverage. The amount payable depends on your policy and claim assessment.

Questions to ask your gynaecologist before you proceed with the procedure

Before agreeing to a hysteroscopy, you can ask these questions to your gynaecologist to help you learn more about this procedure in your case:

• Why do you recommend a hysteroscopy for me? Ask which symptom or scan finding needs investigating, how the results could affect your treatment and whether there are alternatives.
• Will you only examine my womb or carry out a biopsy or treatment as well? Clarify what you are consenting to, including what happens if something unexpected is found.
• What are my pain relief options? Ask whether you will be awake, sedated or under general anaesthesia, and what happens if an awake procedure becomes too painful.
• What are the main risks in my case? Ask about the risks of your specific examination or treatment, rather than hysteroscopy in general.
• How should I prepare, and what will I need afterwards? Confirm fasting and medication instructions, whether someone must take you home, recovery restrictions and whom to contact if you develop concerning symptoms.

How Health in Asia can help

If a hysteroscopy has been suggested to investigate your condition, you may still be deciding whether to proceed or looking for a gynaecologist to discuss the recommendation with. Alongside your questions about the procedure, you may want clarity on where to have it done, the likely cost and your insurance arrangements.

Our Care Team can help you:

• Find a gynaecologist suited to your needs and arrange an appointment.
• Check what your insurance may cover, including whether pre-authorisation or panel requirements apply, before you proceed.

The matching service costs you nothing, and the specialist’s fee is the same as if you booked directly.

We do not diagnose your symptoms, determine whether you need a hysteroscopy or recommend treatment.