There are a number of procedures that can be performed in gynaecology.
Colposcopy
A colposcopy is a simple procedure that allows a gynaecologist to see the cervix, vagina and vulva using an instrument called a colposcope. A colposcopy can be used if some cells from a cervical screening sample were abnormal, or to find out the cause of abnormal vaginal bleeding.
A colposcopy is usually done in the outpatient setting. The procedure occurs with you lying down with your legs in padded supports. A device called a speculum is gently inserted into the vagina and opened. A microscope with a light is then used from a distance to examine the cervix.
During the procedure, liquids may be applied to the cervix to highlight abnormal areas, and a tissue sample (biopsy) may be taken.
If an abnormal area is identified, the surgeon may opt to remove it during the colposcopy using a technique called a loop excision.
Cystoscopy
There are two main types of cystoscopy: a flexible cystoscopy and a rigid cystoscopy.
Both types of procedure involve the use of a thin tube with a light and camera at one end of it called a cystoscope. This is inserted in your urethra (the tube that carries urine out of your body) and up into your bladder to examine it. This cystoscope relays images to a monitor that your consultant can refer to as they perform the procedure. A cystoscopy can help diagnose and treat many conditions that affect your bladder, including bladder stones, recurrent UTIs, and pelvic floor dysfunction.
Hysteroscopy
Hysteroscopy involves passing a thin camera into your womb to view the inside and diagnose any related conditions.
If the aim of the procedure is just to look inside, the procedure can sometimes be performed in the outpatient clinic with some pain relief.
If the intention is to treat a condition, then an operative hysteroscopy is performed. This takes place in an operating theatre, either under general anaesthetic (asleep) or spinal anaesthetic (awake or sedated). A thin telescope is passed into the uterus.
If a condition is identified, it may be possible to treat it then, for instance cutting out fibroids or getting rid of (ablating) excess endometrial tissue. If necessary, samples of tissue (biopsies) can be taken and sent off for analysis.
Recovery from hysteroscopy is usually quick, and you can hopefully go home the same day. You may have some discomfort afterwards, which has been compared to period pains.
Laparoscopic surgery
If your surgeon suspects that the cause of your symptoms may be coming from inside your abdomen, they may suggest performing a laparoscopy. In an operating theatre, with a general anaesthetic (where you are asleep), a thin telescope is passed through a small cut into your abdomen.
Images from the telescope are displayed on a screen for the surgeon and team to see. Here they can examine the inside of the abdomen, as well as look for causes of your symptoms related to the organs.
Many conditions of the uterus, tubes and ovaries can be managed during laparoscopic surgery.
You will be given pain-relieving drugs whilst you are asleep, and advised to continue taking painkillers afterwards.
Transvaginal surgery
Some procedures can be performed via a small incision in the vagina. This is usually less uncomfortable afterwards than a cut on the abdomen.
Operations that can be undertaken this way include those to manage prolapse of the uterus or vaginal prolapse, procedures related to incontinence, or even hysterectomy.
Hysterectomy surgery
Hysterectomy involves removing the uterus. It may be performed to treat heavy periods, long term pelvic pain, non-cancerous growths, or cancer of the uterus, ovaries or cervix.
There are four main types of hysterectomy:
- Total hysterectomy: the uterus and cervix are removed
- Subtotal hysterectomy: the womb is removed, but the cervix is left in place
- Total hysterectomy with bilateral salpingo-oophorectomy: the womb, cervix, tubes and ovaries are removed
- Radical hysterectomy: the womb, tubes, ovaries, cervix, part of the vagina and surrounding tissues such as lymph glands and fat are removed
The hysterectomy is a very common operation. It can be performed via keyhole surgery, via the vagina, or through a cut on the abdomen.
IVF treatment
In-vitro fertilisation (IVF) is designed to help people that are struggling to conceive naturally. It is a procedure in which an egg is fertilised in the laboratory and the resulting embryos are transferred into the womb a few days later.