Appointments, assessments and patient pathways
Outpatient appointments
You will be referred to gynaecology outpatients by your GP. Your GP may have arranged a blood test or ultrasound scan before referring you to hospital.
You will either be seen by a consultant, or by one of our team who will then talk to the consultant if any decisions need to be made about further tests or treatment.
You might need further blood tests or examinations.
If you need further treatment, this will be arranged and a plan of care put in place.
Gynaecology outpatients clinics also provide a number of follow-up and nurse-led clinics. These clinics are led by an advanced clinical practitioner, supported by a clinical nurse specialist, plus nurses and healthcare assistants.
Pre-assessment
Patients are seen in pre-assessment before being admitted for gynaecology surgery. You will be seen by a nurse and a healthcare assistant. They will go through some documentation, which will include asking a number of questions about your health and lifestyle and home circumstances.
You will also have you blood pressure and pulse taken and the nurse will listen to your heart and lungs. Blood tests and swabs are also taken. This is to make you are prepared for surgery and that we have all of the information required.
Our nursing staff will also explain what to expect when to come in for surgery and be able to answer any questions or concerns you may have.
Hysteroscopy
A hysteroscopy is a procedure used to examine the inside of the womb (uterus).
It is usually performed to investigate problems such as unusual vaginal bleeding, and can also be used to diagnose and treat conditions including fibroids and polyps.
A hysteroscopy is usually performed as an outpatient but can be arranged as a day case procedure.
It's carried out using a hysteroscope, a narrow telescope with a light and camera at the end, which is passed into your womb through your vagina. Images are sent to a monitor so your doctor or specialist nurse can see inside your womb.
In some cases, a small piece of lining of the womb will be taken to determine if you need any further treatment. This is called a biopsy. The hysteroscopy procedure usually takes about 10 minutes.
After your operation, a member of the team will explain any follow-up arrangements or any treatments. If a biopsy was taken, the results of this will be given to you at a later date.
Colposcopy
A colposcopy is a simple procedure to look at the cervix, the lower part of the womb at the top of the vagina. It is often done if cervical screening finds abnormal cells in your cervix, or if you have a problem with your cervix.
These cells aren't harmful and often go away on their own, but sometimes there's a risk they could eventually turn into cervical cancer if not treated. A colposcopy can confirm whether cells in your cervix are abnormal and determine whether you need treatment to remove them.
Our colposcopy clinics are run regularly, These are consultant and nurse-led clinics, with all clinicians fully trained in colposcopy assessment and treatment.
Most patients have treatment at the time of their clinic appointment but it can also be performed under general anaesthetic at a later date. This is something that will be discussed with you.
Find out more about Colposcopy's on the NHS website
Northern services
North Devon District Hospital
Main switchboard on 01271 322577
Eastern services
Clinic 2, Level 1, Centre for Women’s Health, RD&E Wonford, Barrack Rd, Exeter EX2 5DW
If you have any questions or concerns, please contact the colposcopy nurses on 01392 406503, or the colposcopy coordinator on 01392 406580.
Mr Mike Hannemann is the Lead Colposcopist.
Vulval clinic
The vulval clinic is a clinic for women with conditions affecting the vulva, lower vagina or perineum. The main reasons you may attend our vulval clinic include: vulval pain, vulval irritations, and vulval lumps.
When you attend the clinic, our specialist will need to examine your vulva and the surrounding area.
This usually includes an internal examination, and swabs and/or a biopsy (a small sample of tissue) may be taken if appropriate.
Treatment
Once you have been seen by a doctor or nurse specialist, treatment options will be discussed with you and your care planned.
If you require treatment to remove abnormal cells following a colposcopy, we will inject the cervix with local anaesthetic to numb the affect area. The abnormality is the removed using a specially-designed electrical loop. The tissue will be sent to the laboratory to be analysed. You will be contacted with the results within four weeks.
The success of your treatment is usually checked by performing a follow-up screening test after six months. In most cases, this is done back at your GP surgery. If the test is abnormal in any way, you will be invited to the colposcopy clinic again for another check-up.
Menorrhagia (Heavy Periods) and Endometrial Ablation
Some women have very heavy bleeding during their period and it is recognised that this can have an effect on their physical, emotional, social and material quality of life. One possible treatment for menorrhagia is to remove some of the tissue lining (endometrium) of your womb. The procedure for doing this is called endometrial ablation and there are a number of methods that can be used including electrocautery, laser ablation and heated fluid. Your healthcare team will discuss with you the various methods of treating menorrhagia and which would be best for you, so that you can make an informed decision.
Hysterectomy
A hysterectomy is an operation to remove the uterus (womb) and sometimes the ovaries and fallopian tubes as well. There are a variety of different reasons why a hysterectomy may be performed e.g. fibroids, inflammation of the lining of the uterus or cancer of the cervix. Before you undergo a hysterectomy your healthcare team will discuss the reasons for the operation and aftercare with you.
Sometimes, a procedure called an operation is needed to help restore the vagina to its normal position and function after a vaginal vault prolapse. Vaginal vault prolapses are where the upper part of the vagina slips down and can occur after a hysterectomy. This operation is called a sacrocolpopexy.
Urodynamic studies
Stress incontinence is a condition where a person wets themselves on exertion. This is diagnosed using a series of tests called urodynamic studies. One possible treatment is colposuspension which involves supporting the bladder with three special stitches.