I have had a borderline/abnormal smear, do I have cancer?

A borderline/abnormal smear means you have pre-cancerous changes not cancer. With a borderline smear you will be asked to have a repeat smear in 6 months’ time when the result will hopefully be normal and no further action will be needed. If the result is still borderline or if abnormal changes are seen then a colposcopy is recommended to determine whether or not further treatment is required. An abnormal smear could mean you have some abnormal changes in your cervical cells that may eventually develop into cancer and these need to be looked at more closely so a colposcopy would be required.

I have been told I need a colposcopy. What is this?

A colposcopy is a visual examination of the cervix which is usually performed in the outpatient clinic. The Consultant uses a colposcope (which is like a large magnifying glass with a light) to have a good look at any cell changes to the cervix. A biopsy is usually taken and sent to the laboratory for a detailed examination.

What is a Hysteroscopy and why would I need to have one?

A hysteroscopy is the visual examination of the inside of the uterus using a thin, lighted, flexible tube (a hysteroscope) which is inserted through the vagina and is attached to a video monitor. You may need a diagnostic hysteroscopy if you are suffering from frequent periods or unexplained bleeding (post coital or post menopausal bleeding). The Consultant will look for possible causes of the bleeding and may take biopsies and/or remove any endometrial polyps (an abnormal growth of tissue) which may be present.

What is a Laparoscopy and why would I need to have one?

A laparoscopy is the visual examination of the inside of the abdomen and pelvis using a long, thin instrument with a light source at its tip (a laparoscope) which is inserted through two small incisions in the abdomen (keyhole surgery) and is attached to a video monitor. A diagnostic laparoscopy is used to investigate unexplained abdominal pain and discomfort, pelvic pain or to assess fertility. An operative laparoscopy is used to diagnose and treat endometriosis, polycystic ovarian syndrome (PCOS), to break down or separate scar tissue (adhesions) or to remove ovarian cysts or ovaries.

What is a biopsy?

A biopsy (ie. a small sample) is the removal of cells or tissues which are then sent to the laboratory for microscopic examination.

It feels like I have a lump in my vagina, what could this be?

You could have a prolapse which needs to be assessed by a Consultant. A repair can be performed to ease your symptoms and to put the bladder, urethra and/or bowel back into their correct position and to strengthen your vaginal wall.

Do I have cancer as I have been told I have an ovarian cyst?

An ovarian cyst is an abnormal cavity within the ovary which contains fluid and is usually not cancerous. However, the cyst will need to be assessed and checked by a Consultant and may be removed as a precaution or if it is causing pain.

Do I have to put up with really heavy and painful periods?

The simple answer is no. There are many solutions for heavy periods (menorrhagia) and a Consultant will be able to recommend the best course of action for you. An endometrial ablation is a simple operation that can reduce heavy bleeding without the need for hormones or a hysterectomy. The lining of the uterus is permanently removed using controlled radio frequency and is very effective. However, the procedure can only be performed if no further pregnancies are being considered and your family is complete. If you may wish to have children in the future then a Mirena coil could be the answer. The Mirena is a small plastic device which is inserted into the uterus and slowly releases a progestogen hormone which helps minimise the bleeding.

What are fibroids and do I need to have them removed?

Fibroids are benign (non-cancerous) growths of muscle and fibrous tissue which vary in size and are found in and around the uterus (womb). If you do not have symptoms then no treatment is required, but if they are causing pain, heavy bleeding or pressure symptoms then there are various treatment options available including medication and surgery. A Consultant will go through the options and decide which is the best treatment for you.

I have to have a Hysterectomy but have been told I will still need to have a smear, why is this?

A Hysterectomy is the removal of the uterus (womb) and can include the removal of the cervix, the ovaries and the fallopian tubes. If the cervix is not removed then you will still need to have regular cervical smears.

I keep getting hot flushes and sweating. Do I need to take HRT?

Hormone Replacement Therapy (HRT) is given to women after the menopause and consists of the hormones oestrogen, progesterone or both. They are used to ease symptoms of the menopause by replacing hormones that are are no longer produced. Not all women need to take HRT as there are many alternative treatments that can be tried if the symptoms are mild, however HRT can help in more severe cases or if the menopausal symptoms are causing distress or preventing you from going about your every day life. There are many different HRT’s and a Consultant will prescribe the ones that you most suitable for you. There have been many scare stories in the newspaper about the taking of HRT and the cancer risks, however they can safely be taken under the care of a Consultant who will discuss the best treatment for you.

What is endometriosis?

Endometriosis is inflammation due to an abnormal growth of small pieces of the womb lining (endometrium) which are found in areas other than the inner surface of the uterus and this may or may not cause symptoms of pelvic pain, painful intercourse, infertility and heavy periods. A laparoscopy can diagnose and treat endometriosis although it may recur at a later date requiring further surgery.

Why do I keep getting urine infections and have to keep taking antibiotic?

Urine infections can be caused by a number of things. If you have more than three a year then the cause needs to be investigated by a Consultant who may perform a cystoscopy, which is a visual examination of the bladder using a fine telescope. Treatment can then be given on an individual basis to help prevent and/or control the number of infections.

I leak urine when I sneeze or laugh but I’m too embarrassed to tell anyone

Please do not be embarrassed – go and see your GP and ask for a referral to a Urogynaecologist who will be able to help you. There are a number of reasons for urinary leakage and you do not have to suffer. Treatment can involve physiotherapy, tablets, a ”lifting” of the bladder or a combination. There is help out there, please ask.

I’m pregnant with my second child and am concerned about a vaginal delivery this time, having had 3rd degree tears first time around. How likely is this?

Further reading at http://blog.theportlandhospital.com/maternity/your-qas-3

I keep contracting cystitis after having had my baby a month ago. How can I prevent this?

Further reading at http://blog.theportlandhospital.com/maternity/your-qas