About Hysteroscopy Clinic
Outpatient Hysteroscopy Clinic
It is envisaged that out patient diagnostic treatment services will dramatically expand in all clincal areas over the next few years. This change is already in process, driven by many factors including advances in the field of medicine, and expansion of patient choice. The latter part of the twentieth century saw reductions in the length of stay for hospital inpatients across the board. These changes now involve transferring traditionally inpatient procedures to day surgey, or even further into the outpatient setting.
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Outpatient hysteroscopy clinics provide a means of delivering both diagnosis and treatments for many gynaecological conditions. The entire female genital tract can be examined with the use of clinical and relatively non-invasive diagnostic tests such as ultrasound, hysteroscopy, and endometrial biopsy. Advances in this field mean greater access to and treatment of benign conditions affecting the uterus and lower genital tract without the need for anaesthetic or sedation.
The outpatient hysteroscopy clinic is the ideal environment to deliver a modern see and treat service. It is also more convenient for a lot of women, as it is less of a disruption to their lives than a stay in hospital and general anaesthetic.
The Hysteroscopy suite has been open for nearly 10 years, and continues to develop and deliver patient focused care in a friendly relaxed environment.
What is a Hysteroscopy?
This is a procedure performed to investigate the cause of abnormal bleeding. It is done as an outpatient visit and does not require a general anaesthetic. Sometimes a local anaesthetic is given if the procedure is uncomfortable for you, although most women do not require this
The procedure is designed to investigate and sometimes make a diagnosis on the same visit. The Doctor or Nurse introduces an instrument called a speculum into your vagina and this enables him/her to see the cervix (neck of the womb). This is the same as when you have a smear. Then a tiny telescope, thinner than a pencil, is inserted through the cervix into your womb. It is connected to a camera and TV screen, which shows the inside of your womb. After this, a tiny piece of tissue (biopsy) from the lining of the womb may be taken and this will be sent to the Laboratory for examination. Sometimes polyps (skin tags) are found and it may be possible to remove these during the test. The Hysteroscopy takes about 10 minutes, you may feel some period type pain, but many women feel nothing at all.
Before your Hysteroscopy you will be seen by a Doctor or Nurse who will explain the test to you and give you a chance to ask any questions.
Why is a Hysteroscopy performed?
This is performed on women who have reported abnormal uterine bleeding. Abnormal uterine bleeding usually falls into one of the following categories:-
Women over 40:
- Any bleeding in between periods (intermenstrual)
- Any bleeding following the menopause
Women under 40:
- Heavy bleeding between periods or heavy periods which do not settle after a few months of treatment
What are the Risks Involved in Hysteroscopy?
A Hysteroscopy is a very safe investigation but on very rare occasions it is possible to suffer a small perforation to the wall of the womb. This will usually close without any treatment, but may result in you needing to stay in hospital overnight so that you can be observed.
Infection is a possible complication although it is rare. If this should happen you may develop a discharge vaginally that may have an unpleasant odour, abdominal discomfort, and maybe a temperature. If you develop any of these symptoms, seek advice from your GP.
What are the Benefits of an Outpatient Hysteroscopy?
The main benefit is that the person performing the Hysteroscopy can view the inside of the womb and take samples, without the need for you to have a general anaesthetic, therefore speeding your recovery, and enabling the procedure to be carried out in the outpatient department.
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You can eat and drink normally on the day of your Hysteroscopy. We advise a breakfast if you have a morning appointment and a lunch if you have an afternoon appointment.
If you are or expect to be bleeding on the day of your hysteroscopy appointment please telephone the Hysteroscopy Unit for advice on 0151 529 2025 (Aintree Centre for Women’s Health) or 0151 702 4147 (Liverpool Women’s NHS Foundation Trust, Crown Street). You can also telephone on these numbers if you need any other advice before your appointment.
On arrival you should attend the Hysteroscopy Unit.
You may then be asked to go to the Ultrasound Scan Department on the ground floor for an Ultrasound scan of the pelvis.
What is an ultrasound examination?
An ultrasound examination obtains a picture of the inside of your body without the use of X-Rays. It is a very safe technique, using sound waves, which pass through the body and are reflected by the internal organs and structures. These ‘echoes’ form a picture on a television screen. The pelvic organs (uterus and ovaries) can then be examined in detail.
Most of the time you will have a vaginal ultrasound scan, but may occasionally have both abdominal and transvaginal.
Vaginal Ultrasound Examinations
Why a transvaginal scan?
A transvaginal scan does not require you to have a full bladder as the probe is close to the pelvic organs, so a good view is obtained of the uterus, ovaries and fallopian tubes – the pictures are much clearer and there is greater detail.
What should I expect?
The examination
You will be asked to go to the toilet and empty your bladder completely prior to the test. This is because a full bladder may prevent a clear view of the other pelvic structures. You will be asked to take off your underwear.
If you have any anxiety about the procedure, please discuss this with the staff performing the examination.
The examination room is usually slightly darkened. The scanning machine and screen, on which the images appear, will be beside the bed. The examination will be performed by an Ultrasonographer, Nurse or a Doctor. You will be made comfortable on a couch and in a position that allows the examination to be performed easily.
The vaginal probe is disinfected before use, covered with a protective sheath and lubricated with jelly to make insertion into the vagina easy and friction free.
The probe is gently inserted into the vagina – it will be similar to having an internal examination. By moving the probe in various directions, all the pelvic structures are displayed on the screen. While the probe is moved you may experience some minor discomfort, but it is not a painful procedure. During the examination a hand may be placed on the lower abdomen to push the pelvic structures nearer the probe so they can be seen more easily on the screen.
The time taken to perform the procedure varies but is usually between 5 – 10 minutes.
Abdominal Scan
Before the Examination
If having an abdominal scan, you will require a full bladder. You should drink two pints of fluid before your scan, the last drink being at least one hour before attending your examination.
The examination room is usually slightly darkened. The scanning machine and screen, on which the images appear, will be beside the bed. An Ultrasonographer, a Doctor or a Nurse will perform the examination. If you are having an abdominal scan (on your tummy), Ultrasound gel will be put on your skin over the area being examined. A small hand held instrument – the probe – is then moved over the skin. The probe causes no pain but if the area is already tender there may be some discomfort.
After your scan you should return to the Hysteroscopy Unit.
After the Hysteroscopy
You will be offered a drink and a chance to talk to the Doctor and Nurse. They will discuss the results of your test and may suggest some treatment options, but they may need to wait for results from the laboratory.
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Any tissue taken at the time of your Hysteroscopy will be sent for examination to the laboratory and you and your doctor will be informed of the result. Following the investigation the tissue will be disposed of in accordance with health and safety regulations.
Before your Hysteroscopy you will be seen by a Doctor who will explain the test to you and give you a chance to ask any questions.
YOU CAN HAVE A FRIEND OR RELATIVE WITH YOU IF YOU WISH THROUGHOUT THE WHOLE OF THIS PROCEDURE
If you need any advice after your appointment please telephone 0151 702 4147 between 9.00am and 4.30pm Monday to Thursday and between 9.00am and 1pm on Friday.
If we are unavailable when you ring there is an answering service and your call will be returned as soon as possible and by the end of the next working day at the latest.
Important advice following the Hysteroscopy
If you
- Feel unwell
- Start bleeding heavily
- Experience pain other than that you would expect when having a painful period
- Or have any concerns
Please contact your GP, The Emergency Room at Liverpool Women’s NHS Foundation Trust on 0151 702 4583 or Ward 4 at Aintree Centre for Women’s Health on 0151 529 3433
For further information visit http://www.2womenshealth.co.uk/
If you would like to make any suggestions or comments about the content of this leaflet, or would like a copy in a different format please contact the Patient Quality Manager on 0151 702 4160 or e-mail liz.edwards@lwh.nhs.uk.
Please note that Liverpool Women’s NHS Foundation Trust is a smoke free site. Smoking is not allowed inside the hospital building or within the hospital grounds, car parks and gardens. Staff are available to give advice about stopping smoking, please ask your nurse about this.
