Minor Gynaecology Procedure clinic

Before your appointment

For most procedures carried out in the clinic it is important that you are not pregnant. If you are sexually active and of child-bearing age, you must use contraception from your last menstrual period before your appointment, otherwise we may not be able to complete your procedure during this appointment.

If you are coming for an IUS or coil replacement, please abstain from sex for the seven days before your appointment or consistently use condoms during this time.

If you are coming for an IUS or coil insertion

This can be inserted at any time during the menstrual cycle, but it is ideally inserted within the first 5-14 days as the neck of the womb may be softer and more open and it also helps to avoid insertion whilst you are pregnant. Please contact us to reschedule if needed.

Your appointment may also need to be rescheduled if you have any of the below issues. Please discuss with one of the nurses (telephone numbers provided at the back of the leaflet) as soon as possible if you:

• are bleeding heavily on the day
• did not use the appropriate contraception as above
• have symptoms of infection like new onset of pelvic pain and/or vaginal discharge (please contact your GP urgently)

For further information please visit:

https://www.nhs.uk/conditions/contraception/ius-intrauterine-system/

You can eat and drink normally before your appointment

For some procedures we may give you a local anaesthetic to numb the area. However, you may still experience some pain after certain procedures, so generally we advise you take simple pain killers (eg. paracetamol) one hour before the procedure. 

What investigations or procedures might I have?

• Speculum or vaginal examination:  This will allow the doctor to assess the cervix (neck of the womb) and if needed, apply a local anaesthetic to numb the area to reduce pain and discomfort.
• Cauterisation: using heat to treat a layer of cells of the cervix (neck of the womb) under local anaesthetic.  This can only be done if a recent smear test is normal.
• Biopsy: small sample of tissue which may be taken from your cervix, lining of the womb, vagina or vulval area. This will be sent to be examined under the microscope. We will give you either a follow up appointment or write a letter with the results.

For vaginal or vulva cysts you may sometimes have a few stitches to stop bleeding. This will not hurt as local anaesthetic will be used.

For insertion or retrieval of an IUS or coil, an ultrasound scan or a hysteroscopy (use of a camera to look inside of the womb) may be required.

You may need to provide a urine sample for a pregnancy test. 

After the procedure

Some procedures (for example taking a biopsy) can cause bleeding. The bleeding will not be heavy but may last a few days. To reduce the risk of infection, use sanitary towels and not tampons for this bleed.

You may be offered an antibiotic to reduce the chance of infection. Continue simple pain killers if you experience any discomfort.

Unprotected sexual intercourse may not be advised – please ask your doctor after the procedure. 

What are the possible complications of these procedures? 

• Abdominal pain, like a period, is commonly experienced with some procedures.
• Mild bleeding is commonly experienced. This may stop immediately or persist as spotting or irregular bleeding for a few months in the case of an IUS  insertion.  
• Less than 1 in 100 chance of infection after the procedure.

In case of a coil or IUS insertion:

• 1 in a 1000 women can have a perforation of the womb at the time of insertion. If you experience ongoing abdominal pain, a scan may be requested and the IUS may need to be removed. Rarely this requires a general anaesthetic.
• A 1 in 200 chance of failure (if pregnancy should occur, there is a higher risk of an ectopic pregnancy).
• A 1 in 20 chance of the IUS being expelled. A six-week thread check is recommended. If the threads cannot be felt or seen, a scan can verify if the coil or IUS is in the correct place. 

When to contact your doctor after the procedure