Women and Children – Gynaecology
When a woman is first told that she has a gynaecological condition that requires further investigation at a specialised hospital clinic, her first reaction is often one of anxiety.
We know that gynaecological conditions are usually difficult for women to talk about and that we are discussing and investigating a very personal aspect of your life. We would, therefore, like you to know that we understand how you might be feeling and to assure you that the clinical staff will deal sensitively and professionally with your problem.
The purpose of this leaflet is to provide information about your hospital appointment in the hysteroscopy clinic and to answer some of the most common questions women want to ask. By understanding more about what to expect, we hope that you will feel less anxious when you attend the clinic.
The leaflet, however, is not a personalised document and there may be some differences between the information given here and your individual case.
Why have I been referred to the hysteroscopy clinic?
There are many reasons why you may have been referred to the specialist hysteroscopy clinic. The most common reasons include:
- Heavy or irregular periods
- Post-menopausal bleeding
- Fibroids or polyps
- Unexplained pain
- The presence of certain endometrial cells on a cervical smear
In the majority of cases there is no abnormality found however it is important to determine the cause of symptoms and to try to resolve the situation, especially if the symptoms are causing disruption to a woman’s normal everyday life.
Nowadays, many women receive all of their gynaecological investigations and treatment in the out-patient clinic and it may never be necessary for them to be admitted into hospital.
What happens when I come to the clinic?
The clinic is relaxed and friendly. Before any physical examination is carried out, the Consultant or a member of his or her team will take a detailed medical history from you.
We will want to know whether you have any other illnesses, whether you have had any operations and whether you are taking any medications. We will also want to know the date of your last menstrual period.
It is usual to carry out a physical examination after your consultation, if a hysteroscopy is appropriate this will also be performed in clinic.
Hysteroscopy takes only a few minutes when performed in the out-patient clinic and avoids the need for a general anaesthetic. A female nurse will be with you throughout the examination but you are welcome to bring a friend or relative with you if you wish.
Please note carefully: If you are on a period it is often not possible to perform this treatment therefore we recommend if you are bleeding at time of appointment to cancel and re book.
The hysteroscopy will not be performed if there is any possibility you may be pregnant at the time of appointment. To make sure you cannot be pregnant please use contraception, or do not have sexual intercourse at all, once you have been told of your hysteroscopy clinic date.
What is a hysteroscopy?
A hysteroscopy is an examination of the inside of the uterus (womb). This is done by using a hysteroscope, a narrow fibre optic telescope which can be passed through the cervix (neck of the womb), and into the cavity of the uterus.
This is usually a simple procedure, especially if women have had children. The hysteroscope is attached to a camera and television system so that the inside of the uterus can be clearly seen on screen. It is also possible for you to watch the screen if you want to.
At the start of the procedure, the hysteroscope is gently inserted through the cervix some fluid is passed through the hysteroscope in order to distend the uterine cavity. Once distended, the shape of the uterine cavity and any irregularities can be seen, as well as the openings of the fallopian tubes.
It is usual to take a sample of the lining of the womb at the end of the hysteroscopy procedure. This is known as an endometrial biopsy. Biopsies are taken and send to the lab this helps to determine a diagnosis on which to base recommendations for treatment.
Is a hysteroscopy painful?
A hysteroscopy may cause some women slight discomfort but this is usually short lasting as the procedure only takes a few minutes. Similarly, the taking of the biopsy may also be uncomfortable (similar to period pains). Simple painkillers such as paracetamol usually provide effective relief. However, we recognise that everyone experiences pain differently, you will be in control at all times. If you are unable to tolerate the procedure the clinician will stop immediately upon your request.
What happens afterwards?
You can expect to have some vaginal bleeding for a day or so following a hysteroscopy, especially if biopsies have been taken. Occasionally, you may find that your next period comes a little earlier than normal and may even be heavier than normal. This is nothing for you to worry about and things will settle down naturally.
You will normally be given your results by telephone or letter, if you prefer we can arrange a further clinic appointment to discuss your results. Your GP will also be given a copy of your results.
Apart from the possibility of vaginal bleeding and mild discomfort, there are usually no lasting effects from an out-patient hysteroscopy procedure and you can continue with all your normal activities as usual.
Diagnostic hysteroscopy is a relatively simple procedure and any associated risks or complications are minimal. Hysteroscopy should not be performed on pregnant women, or if the woman has an infection.
The actual out-patient consultation usually takes about 30 minutes but please allow about an hour for your appointment.
We hope that you have found this information helpful. If you have any further questions or queries regarding the information given, please discuss them with your doctor or contact the clinic staff who will be happy to provide further advice and reassurance.
Contacting Gynaecology Out Patients
If you cannot attend, for any reason, please let us know as soon as possible so that the appointment can be used by another woman and an alternative appointment can be made for you.
Contacting the Appointments Office
The Royal College of Obstetricians & Gynaecologists (RCOG) produces guidelines as an aid to good clinical practice. View them on the RCOG website.
South Tees Hospitals NHS Foundation Trust would like your feedback. If you wish to share your experience about your care and treatment or on behalf of a patient, please contact The Patient Experience Department who will advise you on how best to do this.
This service is based at The James Cook University Hospital but also covers the Friarage Hospital in Northallerton, our community hospitals and community health services.