Why have I been referred to the Gynaecology Rapid Access Clinic?
What tests might I have?
You have been referred for one of the following reasons:
Depending on your symptoms you may have some of the following tests:
You have unexplained bleeding from the vagina, either after you have
gone through “the change” (menopause), or before the menopause
If you have bleeding symptoms, including post-menopausal bleeding,
Something has been seen on your cervix, vagina, or the entrance to
you may have a transvaginal (internal) ultrasound scan.
the vagina (the vulva)
probe is placed inside the vagina bringing it closer to the pelvic organs
You have symptoms of a pelvic mass e.g. abdominal swelling
being examined. It is used to assess uterine (womb) size, the thickness of
We have been asked to give advice about test results by another
the lining of the womb cavity (endometrium), the ovaries and surrounding
clinician or GP
structures. Fibroids and ovarian cysts can sometimes be identified. In
We have been asked to give advice about genetic screening for
some cases you may require an ultrasound scan of the abdomen for
further information. Occasionally we may need to arrange more
It is very important that you attend this clinic appointment, as in some
detailed body scans (CT or MRI Scan).
cases (but not all) there is concern that you may have a cancer.
What will happen on my first visit?
Depending on your bleeding symptoms and ultrasound scan result
You may have some investigations (tests) during your visit. The
you may require an outpatient endometrial biopsy.
This may be
number of tests that you have will depend upon your symptoms,
combined with a procedure called “hysteroscopy” (see below). A thin
therefore please allow at least 2 hours for your visit. These tests often
plastic tube is inserted through the vagina and cervix, into the uterine
give reassurance, or may allow a prompt diagnosis and treatment.
(womb) cavity and a sample taken from the lining (endometrial tissue). This
We would advise you to take simple pain relief such as paracetamol or
is sent to the laboratory for detailed microscopic examination. The
ibuprofen 1-2 hours before your appointment. This is to help reduce any
procedure takes a few minutes and can cause a period-type discomfort.
crampy ‘period’ type pain that you may experience during the procedure.
You may have slight vaginal bleeding afterwards and will need to use a
sanitary pad or panty liner for a day or two.
Either a specialist doctor or nurse will examine you and perform any tests.
You are welcome to bring a friend or relative to keep you company during
the consultation. We shall ensure your privacy, dignity and confidentiality
A fine narrow telescope called a “hysteroscope” is sometimes used to look
during the visit. A changing area will be provided and a nurse will remain
inside the womb.
A trained nurse or doctor will perform this procedure,
with you during your consultation and examination.
which takes about 15 minutes. Local anaesthesia is given to minimise
You may be asked for some or all of the following information at your
discomfort. We will be able to identify any abnormality within the womb,
appointment, so please bring to the clinic if possible:
although in many cases no serious cause for bleeding is found.
Details of your past medical history, including drug allergies
Some women experience period-type abdominal cramps during the
Details and dates of any operations or treatments you have had
procedure, but this will pass quickly once the procedure is completed.
List of any medication you are currently taking, including doses
The most common findings are:
Date of your last menstrual period and cervical smear test
Thickened endometrium – this is the lining of the womb cavity
At the end of your visit we may be able to reassure you there is no cause
Polyps – these are growths of glandular tissue inside your womb
for concern. If required, further investigations or treatment options will be
cavity, or on the cervix, which are usually benign (not cancerous)
discussed and where possible initiated during your visit. (Your diary may
Fibroids – these are muscular lumps (usually benign) in the womb wall
be useful if you need to book further appointments or admission dates).
Thickened endometrium will be biopsied. Findings such as polyps and
fibroids may also be dealt with at the time of your procedure
If you have any questions or anxieties in relation to your test or
If you have a problem that is associated with your cervix you may
treatment, please contact:
require a colposcopy examination.
The cervix is closely examined using
Gynae Nurse Practitioner: 01325 455208
a magnifying lens (colposcope). A doctor or nurse who is trained as a
Oncology Nurse Specialist: 07971895345/
colposcopist will perform this examination. By applying different solutions
Clinic: 01388 455208
to the cervix we are able to detect any abnormality. We may need to take a
small piece of tissue (biopsy) from the cervix and send this to the
If you have any queries about your appointment, please contact the
laboratory for detailed examination. Sometimes we may recommend
consultants’ secretary) on 01325 455184
treatment to the cervix as well.
Date of initial publication: March 2007
Date of this review: September 2017
Date next review due: September 2020
If you have a problem with changes to the skin outside the vaginal
Responsibility for review: Nurse Specialist. BAGH, CLS
entrance (the vulva) a biopsy may be taken.
This is performed if a
Leaflet reference: PIL/CG/0044
lesion is noticed on the vulva. Prior to the biopsy, local anaesthetic is
given. One or more small pieces of tissue are taken from the skin and sent
to the laboratory for detailed examination.
We may need to take some blood tests e.g. to assess possible
ovarian diseases or anaemia.
At the end of my clinic visit …
Following any procedure you will be given an explanation of what was
found, when you will receive any test results, and whether you need
You may be offered refreshments and asked to stay for 10-15 minutes
to make sure you are well after colposcopy or hysteroscopy
a nurse will give you verbal and written advice and discharge
information if any tests have been performed
Occasionally we may have to refer you to another medical specialty or
hospital, but we will discuss this with you if this is required.
If a surgical procedure is advised, arrangements will be made for your
admission date. This may be a day-case procedure but sometimes a
longer stay is required. An appointment for a pre-operative assessment will
also be arranged.
Often we are able to reassure patients at the end of this visit,
following the examination and tests. If no serious cause for your
symptoms are found you will be discharged back to your GP’s care.
Rapid Access Gynaecology Clinic
For assessment of abnormal gynaecological
symptoms (e.g. post-menopausal bleeding);
cervical lesions; pelvic masses