Hysteroscopy, Dilation & Curettage (D&C) in Singapore

Hysteroscopy is a minimally invasive procedure that allows gynaecologists to examine the uterine cavity. This involves the insertion of a scope with an attached camera and light source (hysteroscope) into the uterine cavity to visualise the interior of the uterus for diagnostic or therapeutic purposes. This procedure is often combined with Dilation and Curettage (D&C) to sample endometrial tissue for diagnosis purposes.

Hysteroscopy is the first-line procedure for the evaluation and management of intrauterine abnormalities.

Hysteroscopy can be classified as:

• Diagnostic hysteroscopy: Used to identify intrauterine abnormalities

• Therapeutic hysteroscopy: Used to treat intrauterine abnormalities

Hysteroscopy is typically performed on a day surgery basis under sedation or general anaesthesia.

When Should A Hysteroscopy, D&C Be Done?

Your doctor may recommend a diagnostic hysteroscopy if you are experiencing any of these symptoms:

• Abnormal menstrual bleeding  

• Heavy or prolonged menstrual bleeding (menorrhagia/menometrorrhagia)

• Irregular menstrual cycles (persistent oligomenorrhoea or polymenorrhoea)

• Suspicion of endometrial lesions 

• Suspicion of uterine structural abnormalities

• Bleeding after menopause

• Recurrent miscarriages 

Hysteroscopy helps diagnose structural abnormalities of the uterus, such as:

• Endometrial polyps 

• Submucosal fibroids 

• Intrauterine adhesions

• Uterine septum 

• Endometrial hyperplasia 

If an abnormality is found, a therapeutic hysteroscopy can be performed at the same time using specialised instruments inserted through the hysteroscope. A D&C will also be done to sample the endometrium for further testing.

Is a D&C Always Performed with a Hysteroscopy?

Dilation and Curettage (D&C) is frequently performed in conjunction with hysteroscopy to sample tissue from the uterine lining for histopathological analysis. 

A hysteroscopy-guided D&C offers higher precision than a blind curettage alone, as it enables direct visualisation of the targeted area. This improves diagnostic accuracy and minimises the risk of missing endometrial lesions.

What to Expect During the Procedure

At Daniel Koh Clinic, diagnostic and therapeutic hysteroscopies are performed in an accredited day surgery or hospital setting with appropriate anaesthesia support.

This procedure typically takes 15 to 30 minutes and involves the following steps:

1. Patient preparation: Premedication may be prescribed by your doctor to dilate the cervix. Sedation or general anaesthesia is administered by a trained medical specialist.

2. Hysteroscopy: The hysteroscope is carefully inserted through the cervix into the uterus. A sterile fluid (usually saline) is infused to expand the cavity to enable visualisation. In certain cases, dilatation with metallic rods may be required. The uterine cavity then is assessed for any abnormality.

3. Treatment: If an abnormality is found, hysteroscopic surgery could be performed. This may include removal of polyps, fibroids and/or adhesions.

4. D&C: The uterine lining is gently scraped using a curette to sample endometrial tissue for evaluation in the laboratory.

   
   

Recovery and Aftercare

Patients are monitored closely post-procedure. Most of them would recover quickly after a hysteroscopy, D&C and be discharged on the same day. 

It is common to have mild cramps and light bleeding during the few days post procedure. Most patients can return to normal activities within one to three days.

You may be advised to avoid sexual intercourse, insertion of tampons, and strenuous activity for up to one week. Your doctor will schedule a follow-up visit to review the wellbeing of the patient and the laboratory findings.

Potential Risks and Complications

Although hysteroscopy, D&C procedures are considered safe and major complications are rare, the following risks/complications may occur:

• Vaginal bleeding and discharge

• Pain

• Pelvic infection

• Failure to visualise uterine cavity

• Asherman’s syndrome (Adhesions within cavity of uterus)

• Uterine perforation (0.1-0.8%), with resultant bowels/bladder/vessels damage (rare occurrence)

• Failure to complete the intended procedure

• Fluid overload

At Daniel Koh Clinic, our specialist would undertake the necessary precautions to minimise potential risks to our patients.

Hysteroscopy Cost in Singapore

As per MOH guidelines with effect from 1 Apr 2024, the surgeon fee benchmark for a diagnostic hysteroscopy, D&C ranges from $2,000 to $3,500, and the anaesthetist fee benchmark ranges from $550 to $900. 

The cost of a hysteroscopy procedure in Singapore ranges widely depending on the following factors: 

• Facility type: Public vs Private hospital vs Ambulatory centre

• Subsidy eligibility (Singaporean/PR in public hospitals)

• Complexity: Whether fibroids or polyps are removed during the hysteroscopy (additional fees apply for concurrent therapeutic hysteroscopy)

• Anaesthesia type (local, sedation, or general)

In addition to the surgeon’s fee, a patient’s total bill will also include other components such as operating theatre charges, hospital facility fees, nursing services, medication, anaesthesia-related costs, and laboratory or pathology services (especially if fibroids or polyps are removed). These vary depending on the facility and complexity of the case.

Medisave deductions may apply depending on the procedures undertaken. Please arrange for a consultation directly with Daniel Koh Clinic for a breakdown, depending on your medical needs.

Consult Daniel Koh Clinic for a Hysterescopy, D&C Procedure in Singapore

Hysteroscopy is an essential tool for diagnosing and managing menstrual abnormalities, fertility concerns, and unexplained bleeding. When combined with D&C, it provides both visual confirmation and tissue sampling for effective treatment planning.

At Daniel Koh Clinic, we provide comprehensive women’s health services, including hysteroscopy, D&C procedures, menstrual disorder assessments, and fertility investigations. Management is tailored based on presenting symptoms, diagnostic findings, and procedural outcomes.

Contact Daniel Koh Clinic for an appointment to assess your suitability for hysteroscopy.

Frequently Asked Questions

1. Is hysteroscopy painful?

The procedure is performed under anaesthesia or sedation, so patients do not feel pain during the hysteroscopy. Mild cramping may be experienced afterwards.

2. How long does recovery take after hysteroscopy, D&C?

Most patients return to daily activities within one to three days. Full recovery may take up to a week, depending on the complexity of the procedure.

3. Can I get pregnant after hysteroscopy?

Yes. Hysteroscopy may improve fertility outcomes, especially if intrauterine abnormalities such as polyps, fibroids or adhesions are treated.

4. Will I need a biopsy after hysteroscopy?

If suspicious tissue or thickened endometrium is observed, a biopsy may be taken during the D&C for laboratory analysis.

5. Are hysteroscopy, D&C procedures covered by insurance?

Insurance coverage varies depending on the indication for the procedure and your insurance provider. Reach out to your insurer so that they can advise you on estimated costs and available coverage.