Gynaecology Unit

The Gynaecology Service at Westcliffe health innovation is provided by our specialist consultants and specialist nurses, who are supported by a team of medical staff senior clinicians. We perform Hysteroscopy and Colposcopy procedures in our dedicated Women’s Unit.

A hysteroscopy is a procedure used to examine the inside of the womb (uterus).

It’s carried out using a hysteroscope, which is a narrow telescope with a light and a camera at the end. Images are sent to a monitor so your doctor or specialist nurse can see inside your womb.

The hysteroscope is passed into your womb through your vagina and cervix (entrance to the womb), which means no cuts need to be made to your skin.

When a hysteroscopy may be carried out

A hysteroscopy can be used to:

• Investigate symptoms or problems – such as heavy periods, unusual vaginal bleeding, postmenopausal bleeding, pelvic pain, repeated miscarriages or difficulty getting pregnant
• Diagnose conditions – such as fibroids and polyps (non-cancerous growths in the womb)
• Treat conditions and problems – such as removing fibroids, polyps, displaced intrauterine devices (IUDs or coils) and intrauterine adhesions (scar tissue that causes absent periods and reduced fertility)

A procedure called dilatation and curettage (D&C) used to be common to examine the womb and remove abnormal growths, but now hysteroscopies are carried out instead.

What happens during a hysteroscopy?

• A hysteroscopy is usually carried out on an outpatient or day-case basis. This means you do not have to stay in the hospital overnight.
• You can eat and drink as normal on the day; it is recommended to take over-the-counter painkillers (paracetamol or ibuprofen) 1 hour before your procedure.
• It may not be necessary to use anaesthetic for the procedure, although a local anaesthetic(where medication is used to numb your cervix) is sometimes used.
• A hysteroscopy can take up to 30 minutes in total, although it may only last around 5 to 10 minutes if it’s carried out to diagnose a condition or investigate symptoms.

While you’re recovering:

• you can eat and drink as normal straight away.
• you may experience cramping that’s similar to period pain and some spotting or bleeding for a few days – this is normal and nothing to worry about unless it’s heavy
• you should avoid having sex for a week, or until any bleeding has stopped, to reduce the risk of infection (see below)

Your doctor or nurse will discuss the findings of the procedure with you before you leave hospital.

If you would like to make an appointment with our team please call 01274 623000 and choose the gynaecology option, alternatively you can email private.services@nhs.net

A colposcopy is an examination of the cervix (neck of the womb) using a special microscope called a colposcope which allows us to look more closely at your cervix than during a smear test. The colposcope does not go inside you. The only thing that does go inside is the speculum, the same instrument used when you have a smear test. We spray a dilute solution of vinegar onto your cervix which shows up any abnormal cells.

At Westcliffe Health Innovations you will need to book in at reception and wait until you are called to the room.

You will be asked to confirm your details with the nurse before entering the room. You will be introduced to the nurses and your Colposcopist. Firstly you will be asked some questions about your reason for attending; this is called ‘taking a history’. You will be asked for the result and date of your last smear test and the first day of your last period so please make sure you have these details to hand. If you take any tablets or medicines, the clinician will need a list of those too so please bring one with you. The clinician will answer any questions you may have and explain what is going to happen. If you need treatment, this will be explained and you will be asked to sign a consent form.

You will then get changed and have your colposcopy examination when the clinician will see what the problem is and what needs to be done. There are several possible things that might happen during the appointment:

There may be nothing abnormal to see. You may be advised to have a cervical screening test repeated. This could be at any time between 12 months and 5 years depending on the initial problem

• • Your colposcopist may see some very minor changes and will take some punch biopsies. These are tiny pinches of skin and do not usually need local anaesthetic. They have no harmful effects but you should observe the advice on the page entitled ‘Having a Biopsy’
  • There may be some abnormal cells to see which you may be advised to have treated. This is called a large loop excision of the transformation zone (LLETZ) or loop excision. If this is the case then you will be referred back to your local hospital to have your procedure done there.
  • There may be some abnormal tissue which you are advised to have treated under a general anaesthetic. This doesn’t mean that the problem is more serious. It may be because the area is difficult to get at, or goes deeper into the cervix. If you do have to have this done, your local hospital will aim to get you in as day case as soon as possible.
  • Whatever happens during your appointment, it will all be explained to you and you will have the chance to ask questions. We encourage you to eat normally before you attend and take any regular medication. We recommend that you try to arrange for someone to care for your children whilst you attend your appointment.
  • It is inadvisable to have small children with you if undergoing treatment, as they cannot be in the room with you while you have your procedure.

Any results will be sent to you via SMS text message within 3 weeks of your visit. If you do not have a mobile phone, then please inform the staff so that these can be sent to you in a letter. The SMS text message or letter will contain a plan for follow-up if needed, or will tell you if you have been discharged. We do not give results out over the telephone, so please do not ask or call.

Ectopy, also called ectropion and erosion is a common finding, especially in the young and if you take the oral contraceptive pill. It is rare after the menopause. It is a harmless change where the ‘soft’ (glandular) cells that usually lie within the cervical canal and womb lining appear on the outside of the cervix. This makes the cervix look very red and these cells often bleed easily, especially during intercourse because they are very soft and fragile.

In most cases, an ectopy goes away on its own. You only need treatment if your symptoms are severe and this is done by cauterization also called coagulation. This process destroys the soft cells and in time they are replaced by the firmer flat (squamous) cells which don’t bleed as easily. Even with treatment, the condition can recur.

We do not offer coagulation treatment on your first visit. Coagulation can only be carried out AFTER biopsies are done to rule out any abnormal cells that may need a different treatment. If you decide you want treatment for your symptoms you will have the biopsies done at the first visit and then you would be called back to your local hospital to have the treatment at another time.

These are very common and look like little skin tags with a thin stalk. Most of the time they are harmless, but they can cause bleeding. They can usually be removed easily by twisting the stalk and pulling them off. Anaesthetic is not needed. Sometimes cautery is needed to control bleeding if the stalk is thicker. Anything removed is sent to the laboratory to ensure it contains no abnormal cells. You will be informed of the results by letter within 6 weeks.

A biopsy is a tiny pinch of skin cells taken from the cervix and sent to the pathology lab to find out if there are any abnormal cells present. If they are present the lab will be able to grade them so a plan for treatment can be made if necessary. Usually more than one biopsy is needed and they will be taken at your appointment, you don’t usually have to make a return visit to have them done. Any bleeding will be stopped at the time by applying a special paste or using a silver nitrate stick.

Biopsies have no harmful effects but you are advised:

• To avoid sexual intercourse for 2-4 days
•  Avoid Using tampons for 2-4 days
• Avoid Soaking for a long time in the bath for 2-4 days
• Avoid Excessive exercise for 2-4 days
• You may have a moderate blood loss for up to 6 days
• 1 in 20 women experience pain which may last for 2 days and may require paracetamol to settle

You will be informed of the results by letter within 6 weeks

If your biopsy results were to show any abnormality requiring ongoing review or a further procedure then your treatment plan will need to be completed at your local hospital. Your local hospital will then arrange an appointment to discuss and decide next steps.

If you feel well then after your biopsy then you should be able to go straight home. We advise you to rest for the remainder of the day. You should be able to return to work the following day.

You may experience some bleeding/watery discharge after treatment. This may not start straight away and may last as long as a week.

We ask you to avoid the use of tampons for the discharge. This helps reduce the risk of infection and helps the cervix to heal as quickly as possible.

Sexual intercourse should be avoided for 1 week following the treatment. This again helps the cervix to heal and reduce the risk of infection.

You should have a shower rather than a bath for a week.

You should avoid the use of swimming pools, spas and jacuzzies for 1 week.

If you have any problems relating to a treatment you can speak to a nurse by telephoning: 01274 623029

You’re welcome to have a friend or relative accompany you to your appointment. However, due to limited parking, we kindly ask that they drop you off and return later to collect you, rather than waiting in the car park. This helps keep spaces available for patients who need them most. While they wait, there is a nearby café that supports a local charity. Please note that children are not able to enter the procedure room, so we ask that young children are not brought along on the day.

You can go back to work the day after the biopsy