Common Gynaecological Procedures

An IUD is a small, T-shaped plastic device that is wrapped in copper or contains hormones. The IUD is inserted into your uterus by your doctor. A plastic string tied to the end of the IUD hangs down through the cervix into the vagina. You can check that the IUD is in place by feeling for this string.

The string is also used by your doctor to remove the IUD.

Types of IUDs

• Hormonal IUD. The hormonal IUD, releases levonorgestrel, which is a form of the hormone The hormonal IUD appears to be slightly more effective at preventing pregnancy that the copper IUD. There are two hormonal IUDs – one works for 5 years, and the other works for 3 years.

• Copper IUD. The most commonly used IUD is the copper IUD. Copper wire is wound around the stem of the T-shaped IUD. The copper IUD can stay in place for up to 10 years and is a highly effective form of contraception.

How it works

Both types of IUD prevent fertilization of the egg by damaging or killing sperm. The IUD also affects the uterine lining (where a fertilized egg would implant and grow).

• Hormonal IUD. This IUD prevents fertilization by damaging or killing sperm and making the mucus in the cervix thick and sticky, so sperm can’t get through to the uterus. Its also keeps the lining of the uterus (endometrium) from growing very thick. This makes the lining a poor place for a fertilized egg to implant and grow. The hormones in this IUD also reduce menstrual bleeding and cramping.

• Copper IUD. Copper is toxic to sperm. It makes the uterus and fallopian tubes produce fluid that kills sperm. This fluid contains white blood cells, copper ions, enzymes, and prostaglandins

The IUD (intrauterine device) can be placed in the clinic by a doctor. Prior to placement, it is important that you discuss risks, benefits, and alternatives with our health care professionals to ensure that the IUD is appropriate for you. In addition, please notify us if you are scheduled for IUD placement and suspect that you may be pregnant, develop fever, abdominal pain, evidence of systemic, urinary tract, or vaginal infection, as these must be investigated prior to insertion of the device. If having regular periods, the placement should take place within 7 days of the start of your period to ensure that you are protected from pregnancy on the day you receive the IUD. Please make sure that we are aware if you are breastfeeding as you may be offered a medicine to help relax the cervix to facilitate placement.

Insertion typically takes only take a few minutes which may be associated with mild cramping and spotting. These symptoms often resolve within hours of placement. You may have an atypical discharge after placement. This too should resolve within a few days of placement. We anticipate you being able to resume routine activity the day of placement, but if you develop a fever, severe pain, or heavy vaginal bleeding, please notify us immediately.

Ultrasound is used in gynaecology to examine the pelvic organs. An ultrasound exam can help:

• Identify a pelvic mass
• Find causes of pelvic pain
• Find causes of abnormal bleeding or other menstrual problems
• Find the position of an intrauterine device
• Diagnose and treat infertility

If you are having a transabdominal ultrasound, wear loose-fitting clothes. This will allow your abdomen to be exposed easily. You may need to drink up to six glasses of water during the 2 hours before your exam. This will make your bladder full. A full bladder is necessary because it pushes loops of the bowel up and out of the way, making the uterus easier to see.

For a transvaginal ultrasound, you will be asked to undress from the waist down. You will lie on your back with your feet in stirrups, like a pelvic exam. The transducer for this exam is shaped like a wand. It is covered with latex, like a condom, and lubricated before it is inserted into the vagina. This type of ultrasound can give a closer look at the pelvic organs.

Colposcopy is a detailed examination of the cervix (neck of the womb). A colposcope is a special magnifying glass instrument that allows your doctor to get a clear view of the cells of the cervix and look more closely at the changes. Sometimes the vagina and the vulva (the folds of skin outside the vagina) are examined at the same time. The instrument does not go inside you.

A colposcopy is carried out as an outpatient procedure and should not cause you any pain or discomfort.

During your examination, your doctor will apply various solutions to the cervix, which will make the abnormal cells more obvious. This is not painful.

If your smear suggests that you have only minor changes in the cells of your cervix – which we investigate by looking at the abnormal area – we need to take some small biopsies (samples of tissue) that will be examined in the laboratory. This is to decide on the best follow-up for you (which may be a further smear test, a further colposcopy, or less likely, some treatment). Taking biopsies may cause some brief discomfort.

The examination may last approximately 10-15 minutes, then your doctor will talk to you about the findings of the examination and what happens next.

Treatment successfully treats the abnormal cells in over 90% of women, but it is important to have regular follow-up smears to confirm this.

• What should I do if I have a period on the day of my colposcopy?
  You can still have the colposcopic examination – we would prefer to do the colposcopy towards the last few days of the period when the flow is not too heavy. If you feel particularly awkward about being examined with a period, please contact us.
• Would sexual intercourse interfere with the colposcopy?
  No.

If your GP has referred you to our clinic for colposcopy and you have any further questions before coming down, do feel free to give our nurse a call at 66942162 and we can assist you further.