One-stop gynaecology clinic

The one-stop gynae clinic is held at the Kingston Hospital Willow Unit (Gynaecology Department).

• We advise you to allow 2 to 3 hours for your visit to the clinic.
• You can still attend if you are bleeding vaginally.
• You can choose to bring one family member or friend with you.
• Do not bring children with you, because we cannot accommodate them.

Why you have been referred

Your GP has referred you to see us because you are experiencing abnormal bleeding from your uterus (womb). This is often called 'abnormal uterine bleeding'.

You may or may not be using HRT (hormone replacement therapy).

When you arrive, we will aim to see and treat you during the same appointment. Some patients will need additional tests or investigations. We will refer you to another specialist if this is needed.

Preparing for your appointment

To prepare for your appointment, we recommend you do the following.

• Take painkillers such as paracetamol (1g), ibuprofen (400mg) or your usual pain relief. Do this approximately 1 hour before your appointment.

If you have questions about your appointment, call the Gynaecology Department on 020 8934 6407.

Who you will see

You will see a team of specialist doctors and nurses, led by one of our senior gynaecologists.

You will always have a female chaperone with you during your examination.

If you wish to be seen or examined only by a female doctor, call our administration team on the contact details at the bottom of this leaflet. 

During your appointment

You can expect the following during your appointment. (For more detail, see Typical procedures, below.)

• The doctor will take a detailed history of your symptoms.
• They will examine your abdomen.
• They are likely to perform an ultrasound scan (usually through your vagina).
• They may also perform a hysteroscopy. This means using a camera to look at the inside of your womb (uterus).
• They may take a biopsy (small tissue sample) from your uterus.

Typical procedures

Transvaginal ultrasound

This means we insert the tip of a probe into your vagina. This allows us to make a detailed assessment of your cervix (neck of your womb), uterus (womb), fallopian tubes and ovaries.

To do this, we need you to empty your bladder (urinate) before the procedure.

We usually ask patients to give us a urine sample when they do this, to check if they are pregnant. (We need to check that you are not pregnant, in case you need a hysteroscopy, which involves an examination of your womb.)

The procedure usually takes a maximum of 15 minutes. It is painless for most patients.

The results of the transvaginal ultrasound will indicate whether we need to take a biopsy, remove a coil or perform a hysteroscopy.

Uterine biopsy 

A uterine biopsy means we take a tissue sample of the lining of your womb (uterus). We do this so tests can be performed on the sample.

To take the sample, we insert a speculum into your vagina so that we can clearly see your cervix (the neck of your womb). This procedure is similar to a regular smear test.

The procedure can be uncomfortable, but it only takes a maximum of 5 minutes.

Removal or insertion of coil

To remove or insert a coil, we insert a speculum into your vagina so that we can clearly see your cervix (the neck of your womb). This procedure is similar to a regular smear test.

The procedure can be uncomfortable, but it only takes a few minutes.

Hysteroscopy

A hysteroscopy is a procedure to examine the inside of your womb (uterus).

To do this, we pass a hysteroscope through your cervix (the neck of your womb) and into your uterus. A hysteroscope is a thin telescope with a tiny camera on the end.

We then use saline fluid to view the inside of your uterus.

During the procedure you may feel a trickle of saline coming from your vagina.

If we identify a polyp (fleshy growth) or fibroid (non-cancerous growth) during this investigation, we may remove it at the same time.  Sometimes we schedule its removal for another date.

Your doctor will discuss this with you during your appointment. If necessary, they will also talk to you about the best treatment plan for you.

The procedure lasts up to 10 minutes. If it becomes too painful, we can stop and discuss other options with you.

Hysteroscopy risks and side effects

• pain
• bleeding
• infection (rare)
• failure to insert the hysteroscope through the cervix
• perforation (tearing) of the uterus (extremely rare).

Your results

• We understand that this is an anxious time for you, so we will let you know your results as quickly as possible. We will give you these by text message or by telephone.
• We will provide more detailed results in either a letter or telephone appointment.

Follow up

• If you need follow-up based on your symptoms or results, we will arrange this for you.
• If further action is needed, we will offer you a detailed discussion about the outcome of your tests and any other investigations, treatment or support.