Diagnostic Hysteroscopy is performed to diagnose or exclude endometrial pathology – abnormalities of the womb lining. A small telescope camera is passed through the neck of the womb and an image of the inside of the womb is seen on a monitor. The procedure takes less than 10 minutes and allows Olivia to check for polyps, fibroids growing inside the womb, pre-cancerous or cancerous abnormalities. The camera is then removed and a biopsy sample of the womb lining is taken. If no abnormality is seen you may choose to have a Mirena IUS (hormone coil) fitted at the end of the procedure to help with problematic periods, as part of HRT or contraception if this is appropriate for you. If polyps or fibroids are found inside the womb, you will be offered a Myosure procedure to remove them.
A view inside a normal womb with a hysteroscope
Daycase Hysteroscopic Procedures are ideal for women who have abnormal bleeding problems but don’t wish to have the inconvenience of needing to take too much time off work. Olivia is among a small group of gynaecologists in Leicester who have developed this service in the NHS. She is the gynaecologist with the most experience in these procedures working at Spire Leicester Hospital.
Myosure is a safe, effective and fast way of removing polyps, fibroids or even directed biopsies under vision from inside the womb with only minimal discomfort. Polyps or submucous fibroids (where they bulge into the womb cavity) may contribute to or cause heavy painful periods, bleeding in between the periods or after the menopause. Removing them is likely to treat these problems. Removing the lesions also allows for analysis of the tissue fragments to check for pre-cancer and cancer within the lesions.
Olivia and her Ambulatory team at LGH
Novasure is a highly effective way of managing heavy periods, particularly over the age of 40. It works by cauterising (burning) the womb lining thereby significantly reducing the heaviness of the periods or stopping them altogether. Success rates are over 90%. You must have completed your family as pregnancy following endometrial ablation is potentially very dangerous.
Novasure is not an appropriate choice for you if you have any risk factors for endometrial cancer or hyperplasia (for example past polyps or hyperplasia, obesity, genetic mutations which increase the risk of womb cancer (BRCA, Lynch Syndrome) as it will not be possible to access the womb cavity after the procedure. If you suffer with fibroids and or endometriosis or you are suspected to have adenomyosis, Novasure is not a good idea as it is likely that period pains will increase even if you have a good result in terms of the bleeding. 1 in 10 women experience new cyclical cramps. 1 in 20 women will need a hysterectomy after Novasure ablation.
For these reasons, it is best to consider all alternative treatment options for heavy periods before undergoing Novasure ablation as if you have problems after an ablation – treatments are limited to hormone tablets, NSAIDs and tranexamic acid or Hysterectomy.
If you prefer to undergo your hysteroscopic procedure under local anaesthetic Olivia can perform these at Spire Leicester Hospital but in the theatre setting as a daycase. You can choose to have your procedure under local anaesthetic; with or without sedation or under general anaesthetic.