This is an HTML version of an attachment to the Freedom of Information request 'Outpatient hysteroscopy/biopsy - RCOG/BSGE 2018 statement on Pain Control and Patient Choice'.

Information leaflet on
“One-Stop”

“See & Treat”
Hysteroscopy
Clinic
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Your first visit
•  You have been referred to the “One-Stop” “See & Treat” 
Hysteroscopy Clinic’ by your doctor.
•  The purpose of the clinic is to identify the cause of your 
problem and start treatment (if necessary) in just one visit 
(“One Stop”).
•  You may be asked to have an ultrasound scan before  
seeing the doctor. This will be done in a different  
department but in the same hospital.
•  You will be seen and examined by a Consultant, Registrar 
or Nurse Hysteroscopist, who may advise you to have a 
hysteroscopy which involves looking inside your womb 
with a camera.
•  If an abnormality is found, you may be offered a  
treatment at the same time, i.e. removal of a polyp/fibroid 
(“see and treat”). This may be done with or without the 
use of a local anaesthetic and gas and air.
•  You can eat and drink as normal. It can also be beneficial 
to take a simple pain killer around 30 minutes before your 
scheduled appointment.  Something that you may have 
taken for period pain would be appropriate e.g.  
paracetamol or ibuprofen.
•  If you want the hysteroscopy or any other treatment  
under a general anaesthetic (i.e. with you asleep) then we 
can arrange that for you at a later date.
If you have any queries before your visit, please telephone: 
0121 335 8101.
If you think you could be pregnant then please inform 
nursing staff or doctor before your procedure so that they 
can offer you a pregnancy test.

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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 disease - abnormalities in the womb 
lining can be seen.
It is common not to find any abnormality. This can be  
reassuring that there is nothing seriously wrong. Other  
treatments can then be considered and will be offered.
What are the benefits of the procedure?
A hysteroscopy will normally allow the doctor to make an  
accurate diagnosis and offer appropriate treatment at the 
same visit. Often a biopsy can be performed at the same time 
as the hysteroscopy.
Are there any alternatives to the procedure?
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.
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It is important to realise that a scan and biopsy cannot  
It is important to realise that a scan and biopsy cannot  
identify all conditions and a hysteroscopy may still be  
identify all conditions and a hysteroscopy may still be  
recommended even if your results are normal. Your doctor 
recommended even if your results are normal. Your doctor 
can discuss the options with you.
can discuss the options with you.
What will happen if I decide not to have the  
What will happen if I decide not to have the 
procedur
pr
e?
ocedure?
Your doctor will only recommend a hysteroscopy if it is 
Y
 
our doctor will only recommend a hysteroscopy if it is  
entirely necessary. Choosing not to have the procedure is 
entirely necessary
 
. Choosing not to have the procedure is  
entirely your choice but then you may be denying the right 
entirely your choice but then you may be denying the right 
treatment for you.
treatment for you.
What does the procedur
What does the pr
e involve?
ocedure involve?
A hysteroscope is a small telescope that is passed through the 
A hysteroscope is a small telescope that is passed through the 
neck of the womb to see the inside. It is usually performed in 
neck of the womb to see the inside. It is usually performed in 
less than ten minutes. Fluid is used to pass the hysteroscopy 
less than ten minutes. Fluid is used to pass the hysteroscopy 
to give a clear view. This can give you a feeling of being wet. 
to give a clear view. This can give you a feeling of being wet. 
You may also experience some crampy “period like” pains. 
You may also experience some crampy “period like” pains. 
This is usually shortlasting.  If polyps/fibroids are seen these 
This is usually shortlasting.  If polyps/fibroids are seen these 
can be removed by using additional instruments (figure 1).
can be removed by using additional instruments (figure 1).
Your first visit
It is common not to find any abnormality. This can be 
Uterus (womb)
reassuring that there is nothing seriously wrong. Other 
•  You have been referred to the “One-Stop” “See & 
treatments can then be considered and will be offered.
Treat” Hysteroscopy Clinic’ by your doctor.
•  The purpose of the clinic is to identify the cause of 
What are the benefits of the procedure?
your problem and start treatment (if necessary) in just 
one visit (“One Stop”).  
A hysteroscopy will normally allow the doctor to make 
•  You may be asked to have an ultrasound scan before 
an accurate diagnosis and offer appropriate treatment at 
seeing the doctor. This will be done in a different 
the same visit.  Often a biopsy can be performed at the 
department but in the same hospital.
same time as the hysteroscopy.
•  You will be seen and examined by a Consultant, 
Figure 1.
Registrar or Nurse Hysteroscopist, who may advise 
A  hysteroscope is passed into the womb to allow 
Are there any alternatives to the 
the surgeon to examine the lining of the womb
you to have a hysteroscopy which involves looking 
procedure?
inside your womb with a camera.
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•  If an abnormality is found, you may be offered a 
It may be appropriate to try and find the cause of your 
What risks or complications can happen?
treatment at the same time, i.e. removal of a polyp/
symptoms using a scan and by performing a biopsy 
There is a very small risk that the instruments used could 
fibroid (“see and treat”).  This may be done with or 
using a small tube placed through the cervix (neck of the 
puncture the wall of the womb.  However, because 
without the use of a local anaesthetic and gas and air.
womb). Sometimes it is not possible to place the small 
this procedure is viewed on a television monitor as it 
•  You can eat and drink as normal. It can also be 
tube into the womb, or to get enough tissue. 
is performed, and the doctor can see exactly what is 
beneficial to take a simple pain killer around 30 
happening, this risk is very small.
minutes before your scheduled appointment. 
It is important to realise that a scan and biopsy cannot 
identify all conditions and a hysteroscopy may still be 
Pain, this happens with every operation but if you find 
Something that you may have taken for period pain 
recommended even if your results are normal.  Your 
that the procedure is painful, you can ask the doctor 
would be appropriate e.g. paracetamol or ibuprofen.
doctor can discuss the options with you.
or nurse to stop or give you more pain relief. Pain after 
•  If you want the hysteroscopy or any other treatment 
hysteroscopy is usually mild (similar to a period) and is 
under a general anaesthetic (i.e. with you asleep) then 
What will happen if I decide not to have 
usually controlled with simple painkillers, however, if 
we can arrange that for you at a later date.
you require more pain relief this will be arranged. We 
the procedure?
If you have any queries before your visit, please
will ask you to stay in the unit for about 20 minutes 
telephone: 0121 607 4733 or 0121 607 4705.
Your doctor will only recommend a hysteroscopy if it is 
after the procedure to make sure the pain has settled.
entirely necessary. Choosing not to have the procedure 
Bleeding, which is usually mild (similar to a period), 
Why do I need a hysteroscopy?
is entirely your choice but then you may be denying the 
settles within a few days.  It is important to use sanitary 
right treatment for you.
Your symptoms suggest you may have a gynaecological 
towels, not tampons.
problem but the exact cause has not been found so far. 
What does the procedure involve?
Infection, which may cause an unpleasant-smelling 
A hysteroscopy will help to find out if you have one of 
vaginal discharge or persistent bleeding.  Infection is 
the following conditions:
A hysteroscope is a small telescope that is passed 
rare and is easily treated with antibiotics.
through the neck of the womb to see the inside. It is 
•  Fibroids - a fibroid is an overgrowth of the muscle of  
usually performed in less than ten minutes.  Fluid is used 
the womb.
Specific complications of this procedure?
to pass the hysteroscopy to give a clear view. This can 
•  Polyps - a polyp is a small skin tag that looks like a  
give you a feeling of being wet. You may also experience 
Making a hole in the womb with possible damage 
small grape on a stalk. 
some crampy “period like” pains.  This is usually short-
to a nearby structure.  This is rare and happens if one 
•  Endometrial disease - abnormalities in the womb  
lasting.  If polyps/fibroids are seen these can be removed 
of the instruments makes a small hole in the womb or 
lining can be seen.
by using additional instruments (figure 1). 
cervix (risk: less than 8 in 1000).  
Cont/d...

What risks or complications can happen?
There is a very small risk that the instruments used could 
puncture the wall of the womb. However, because this  
procedure is viewed on a television monitor as it is  
performed, and the doctor can see exactly what is happening, 
this risk is very small.
Pain, this happens with every operation but if you find that 
the procedure is painful, you can ask the doctor or nurse to 
stop or give you more pain relief. Pain after hysteroscopy is 
usually mild (similar to a period) and is usually controlled with 
simple painkillers, however, if you require more pain relief 
this will be arranged. We will ask you to stay in the unit for 
about 20 minutes after the procedure to make sure the pain 
has settled.
Bleeding, which is usually mild (similar to a period), settles 
within a few days. It is important to use sanitary towels, not 
tampons.
Infection, which may cause an unpleasant-smelling vaginal 
discharge or persistent bleeding. Infection is rare and is easily 
treated with antibiotics.
Specific complications of this procedure?
Making a hole in the womb with possible damage to a  
nearby structure.
 This is rare and happens if one of the  
instruments makes a small hole in the womb or cervix  
(risk: less than 8 in 1000).
If this happens, you may need to stay in hospital overnight 
for close observation in case you develop complications. 
Sometimes a further operation will be needed (risk: less than 
1 in 1000).
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Failed procedure, where it is not possible to insert the  
hysteroscope through the neck of the womb and inside the 
womb. This is rare.
How will I feel afterwards?
You may get some crampy period type pains which usually 
settles quickly. Simple painkillers will usually be enough if this 
lasts for longer.
You may also get some spotting or fresh blood loss.
Going home
After the procedure you will be able to rest and have a cup of 
tea in comfortable surroundings. It is advisable to have  
someone with you when you go home.
At home
You will need to rest for the remainder of the day.
You may continue to get some spotting or fresh blood loss for 
the next day or so.
If you do require further pain relief, we suggest simple  
painkillers such as paracetamol every 4 hours (maximum of 8 
tablets in 24 hours).
Other Information
Before you leave the clinic you will be told whether the  
hospital needs to see you again. In this case an Outpatient 
Department appointment will be made.
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Finally, please remember if you have any worries or concerns 
following your appointment please contact:
One Stop Clinic 0121 335 8101
Monday - Thursday 8.30am - 5.00pm
Friday 8.30am - 12.00pm
otherwise
Ward 8, Birmingham Women’s Hospital on
0121 335 8180
To arrange or cancel an appointment please contact
0121 335 8101
Questionnaires
Before and when you attend the clinic you may be asked to 
complete feedback and research questionnaires so that we 
can continually strive to improve our services.
Research & Audit
As part of our ongoing research and audit, we would like to 
include your details and findings from the clinic appointment 
on a specialised computer database.
This confidential database may be used for future research 
and audit projects. Part of these projects would be looking at 
the long-term benefits of these specialised services. This may 
involve contacting you in the future by postal questionnaires.
We hope that you are happy with this but if you have any 
objections then please let the staff know when you
attend the clinic.
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We have updated our Privacy Notices in line with the data 
protection legislation (General Data Protection Regulation 
(GDPR)/Data Protection Act 2018.  For more information 
about how we use your personal data please visit our website 
at:
https://bwc.nhs.uk/privacy-policy
Birmingham Women’s Hospital
Mindelsohn Way
Birmingham B15 2TG  
Website: www.bwc.nhs.uk
Authors:  Professor Janesh Gupta - Consultant Gynaecologist & 
Mr Justin Clark - Consultant Gynaecologist 
Produced: 06/2018
Review Date: 06/2021 
Version 1.0
Ref: 64
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