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Services & Specialities

Gynaecology

Hysteroscopy

What is a hysteroscopy?

A hysteroscopy is a procedure to look at the inside of the uterus (womb) using a small telescope (hysteroscope). It is common for a biopsy to be performed at the same time (which involves removing a small piece of the lining of the womb).

Your surgeon has recommended a hysteroscopy as it is good for finding out the cause of abnormal bleeding from the womb, especially heavy periods and bleeding after the menopause. However, it is your decision to go ahead with the procedure or not.

Why do I need a hysteroscopy?

Your symptoms suggest you may have a gynaecological problem but the exact cause has not been found so far. A hysteroscopy will help to find out if you have one of the following conditions.

• Fibroids - A fibroid is an overgrowth of the muscle of the womb.
• Polyps - A polyp is a small skin tag that looks like a small grape on a stalk.
• Endometrial cancer - By performing a biopsy of the lining of the womb, endometrial cancer ( a malignant growth in the lining of the womb) can be diagnosed.
• Abnormally-shaped womb - This is sometimes associated with abnormal uterine bleeding or miscarriages.

If your surgeon finds the cause of your symptoms, they will discuss the appropriate treatment with you. It is very common not to find an abnormality. You can then be reassured that there is nothing seriously wrong. Other treatments can then be considered.

What are the benefits of hysteroscopy?

A hysteroscopy will normally allow your surgeon to find out the cause of your problem and to decide on the best treatment for you.

Are there any alternatives to a hysteroscopy?

It may be appropriate to try and find the cause of your symptoms using a scan and by performing a biopsy using a small tube placed through the cervix (neck of the womb). Sometimes it is not possible to place the small tube into the womb, or to get enough tissue.

It is important to realise that a scan and biopsy cannot identify all conditions and a hysteroscopy may still be recommended even if your results are normal. Your surgeon can discuss the options with you.

What will happen if I decide not to have the procedure?

Your surgeon may recommend a scan and biopsy to find out more information. However, this may not accurately find out the cause of your symptoms. Choosing not to have the procedure may make it more difficult for your surgeon to deceide on the best treatment for you.

Further information:

You can also get further information from:

www.aboutmyhealth.org - for support and information you can trust,
www.eidohealthcare.com

Colposcopy

What is a Colposcopy?

Your consultant will have told you that you need to have a colposcopy. This is when the consultant uses a bright light and a microscope to look at your cervix.

What will happen during the procedure?

The preparation is the same as for when you have a cervical smear. During this procedure, a solution of weak acetic acid (vinegar) is used to dab the cervix. This will then show up any abnormal cells as they will change colour.

Should any abnormal cells be present, the consultant will be able to identify them and take a small biopsy to send away for further analysis.

What after affects will I feel?

If a biopsy is taken you may experience some slight period type pains and a dose of your usual painkiller or some paracetamol should alleviate this. A small amount of blood loss is expcted. This will turn into a brownish discharge which will be present for a few days after having a colposcopy. You should use a sanitary towel, not a tampon as this may stick to the cervix and cause further bleeding when removed.

If the blood loss persists and your period is not due, or if the loss becomes heavy or smells offensive you are advised to contact your consultant for further advice.

What happens next?

Your consultant will discuss the findings of this examination with you adn will make arrangements for any further appointments or investigations.

If you have any queries or problems, please do not hesitate to contact the outpatients department on 020 7234 2107.

Loop Diathermy

What is a Loop Diathermy?

Your doctor will have advised you that you need treatment on the area that is causing your smear to be abnormal. It is a minor procedure and you will need to be prepared in much the same way as when you are having a cervical smear - the difference being that you will be given a local anaesthetic into the cervix at the beginning of the procedure.

In many cases this will be the only treatment that you will need although you will require follow up colposcopies to make sure that you have healed well and that there is no reoccurence of abnormal cell growth.

What happens during the procedure?

The aim of the loop diathermy or Lletz, as it is otherwise known, is to remove the area of cells which are abnormal so that they may be looked at under the microscopefor further investigation.

The procedure itself only takes a few minutes to perform. After it is over you will be offered a drink and asked to remain in the department for ten minutes to make sure that all is well, as it can make some people feel a little bit shaky, this is due to the effect of the local anaesthetic.

What happens after the procedure?

You are advised to go home and rest and not do anything strenuous for the rest of the day and not to drive for a few hours following the procedure. Some people experience period-like pains and a dose of your usual painkiller or some paracetamol will help this.

Within the first 24-48 hours you may get some fresh bleeding which will be followed by a slight brown discharge with some black particles in it, this will last for a few weeks and is to be expected.

Important: If you do find that you are bleeding heavily you must seek advice from your consultant as soon as possible. Similarly if the discharge becomes offensive smelling or you are experiencing any further pain it is best to contact your consultant for advice.

What other advice should I take?

Do not use tampons until after your next period and you are advised to avoid sexual intercourse for about 3-4 weeks after the procedure, to allow time for the cervix to heal and for the discharge to stop.