Gynaecology in Bristol

Do you find it difficult to find time to look after you? Juggling commitments and daily life can sometimes mean less time to look after yourself and your health. We understand that when you have concerns about your health, you want to find a solution, quickly and easily.

At Nuffield Health Bristol Hospital, The Chesterfield you will be treated with care and consideration. The tranquil surroundings of our hospital provide a relaxing and peaceful environment whether you are here as an outpatient, for the day or overnight for any period. With our on-site diagnostic and imaging services and physiotherapy department, we can provide fast access to screening and tests to support your treatment pathway.

Our experienced and professional Consultant Gynaecologists in Bristol are here to help with a wide range of services including (but not limited to): advice, scanning and surgery for problem periods, hysterectomy, menopause, prolapse, colposcopy, urinary incontinence and many other services.

Below we provide some insight into common gynaecological conditions and how we would help to treat them.

Problem periods

If you are having unusually painful and heavy periods, you’ll know it can often stop you doing what you need to do. Heavy, painful menstrual bleeding does not mean there is anything seriously wrong but we do offer treatments that may help, and make a difference to your quality of life. Why feel uncomfortable when there are so many things you want to get on with? Problems with periods may be caused by fibroids, endometrial polyps or endometriosis – all of which we can treat safely and effectively.

Fibroids in the womb

Fibroids are quite common. They are tissue lumps that grow in or around your womb. It is not known what causes them to grow. They can be as small as a pea, or as large as a melon. They don’t turn into cancer, but you may find they sometimes result in:

• Heavy or painful, long periods
• A feeling of fullness or discomfort in your pelvis
• Having to pass urine often
• Pain during sex
• Back pain

We start by making a diagnosis with an ultrasound scan of your pelvis or an MRI scan. MRI stands for medical resonance imaging, which shows detailed 2D or 3D pictures of your body to locate and measure any fibroids. These tests can be taken as an outpatient, so you do not have to stay in hospital.

How we can help you if you have fibroids in the womb

• Hormone treatment - this is in the form of medication and can be used to reduce the size of fibroids prior to surgery, or in some cases, instead of surgery. Your consultant can tell you if this is suitable in your case.
• Endometrial ablation - this is usually only carried out if the fibroids are near the surface of the womb. The lining of the womb (that is shed each month) is removed. It can be performed under general or local anaesthetic.
• Myomectomy - this is usually performed under general anaesthetic. The fibroids are removed from the womb either through an incision in the abdomen or via the vagina.
• Hysterectomy - this is surgery to remove the womb. This option is always very carefully considered and only used if the fibroids are very large, and if other treatments have been advised beforehand.
• MR-guided Focused Ultrasound Surgery (MRgFUS) - this is minimally invasive, low risk fibroid treatment, involving no hospital stay, and a quick recovery.

Endometrial Polyps:

Endometrial (or uterine) polyps are growths in the lining of the womb. They vary in size but usually remain quite small. Occasionally, if attached to a long stalk, they can protrude through the neck of the womb.

If the polyps are troubling you, you may experience:

• Bleeding between periods
• Bleeding after sex
• Heavy periods
• Bleeding after you have had the menopause 

How can we help you if you have endometrial polyps. We begin with tests to diagnose any polyps. These may include a hysteroscopy. With this test, a telescope with a camera attached is passed into the womb to examine it. Although polyps can sometimes return, they can be removed by a simple operation. They can be cut free from the wall of the uterus, during a hysteroscopy. This is usually done under general anaesthetic, as a day case or overnight stay. We may also perform an endometrial biopsy, where we take a small piece of womb lining to be examined.

Endometriosis

Endometriosis is a condition where the tissue that’s usually found in your womb grows in other areas. The tissue thickens and bleeds during your monthly cycle, but the blood cannot escape through the vagina, so the trapped blood irritates tissue around it. This can cause pain and scar tissue. We aim to offer treatments to ease the symptoms so that you can continue with your normal lifestyle.

How we can help if you have endometriosis

Our specialists can investigate using certain tests. These include a laparoscopy, a common test where a telescope is passed through a small incision near the navel, to look at the organs in your pelvis. It can help to find out if you have endometriosis, fibroids, ovarian cysts or damaged fallopian tubes. Depending on your particular case, different treatments are available.

They include:

• Medication for pain management 
• Hormone treatment
• Keyhole surgery (using a laparoscope to treat an area of endometrial tissue)
• Hysterectomy (usually only considered if your family is complete and you symptoms are particularly extreme)

Screening for cervical cancer

Why is cervical screening important?

It is sensible to be screened regularly as spotting any changes in cells early on can often prevent cervical cancer. A cervical screening test (or smear test) looks at the health of your cervix and for any abnormal cells. Early detection and treatment of any abnormal cells can prevent cervical cancer developing. You can ask us any questions you like during screening. Our experienced staff are always on hand to comfort and reassure you.

Who should have a cervical smear?

Women aged between 25 and 50 should be screened every three years. If you are a woman aged between 50 and 65, it’s best to be screened every five years.

What happens in a cervical smear?

A speculum is inserted into the vagina, which can be uncomfortable, but shouldn’t be painful. A small brush is used to take a sample of cells from the lining of the cervix and deposited either on a slide (sometimes called a ‘smear’ test), or in a preserving fluid. It is then sent to the laboratory to be examined. Any early changes in the cells of the cervix can be seen.

How we can help if we find abnormal cells

Treatment for abnormal cells can vary. It’s likely you’ll go and see a gynaecologist for treatment, which may include:

• Colposcopy - a microscope is used to examine the cells on the cervix in more detail, and further treatments can be performed to remove or destroy the abnormal cells. You generally don't stay overnight for this procedure, but are seen as an outpatient (day case).
• LLETZ (large loop excision of the transformation zone), sometimes called LEEP (loop electricosurgical excision procedure) - this procedure removed the abnormal cells with a thin wire loop. This is usually done under a local anaesthetic. The removed tissue may then be sent to the laboratory for examination.
• Laser therapy (or laser ablation) - this treatment destroys abnormal cells by vaporising them with a hot beam of light. 
• Cryotherapy - a cold probe is used to freeze away the abnormal cells
• Cone biopsy - a minor operation to remove a cone of tissue from your cervix where the abnormal cells are located. This biopsy is usually done under general anaesthetic as a day case or overnight stay. The tissue is then sent to the laboratory for examination.

Find out more about our gynaecological consultants