Outpatient Hysteroscopy Clinic
Role of the service
This clinic provides a service for women across WA who require the investigation of the following issues as an outpatient without a general anaesthetic. This service is also an option for those whom medical co-morbidities would preclude them from having a general anaesthetic to investigate their gynaecological issues.
- Abnormal bleeding including heavy menstrual bleeding.
- Postmenopausal bleeding.
- Intermenstrual bleeding.
- Postcoital bleeding.
- “See and treat” uterine polyps / submucosal fibroids.
Clinical inclusion
History of abnormal bleeding requiring further investigation:
- Heavy menstrual bleeding.
- Intermenstrual bleeding.
- Post coital bleeding.
- Uterine polyp or submucosal fibroid requiring treatment.
- Post-menopausal bleeding.
- Asymptomatic endometrial thickening requiring investigation.
Clinical exclusion
Patients who are unable to tolerate an outpatient procedure.
A pamphlet is provided to patients to explain pre-hysteroscopy recommendations for analgesia. Local anaesthetic can be provided. As this is an outpatient clinic, sedation and general anaesthetics cannot be offered. Direct referrals for those unable to tolerate an outpatient procedure to General Gynaecology.
Frequency of clinic
Tuesdays.
Referral to include
- Detailed history of abnormal menstrual history and clinical concern.
- Medical and surgical history, medications and allergies.
- Menopausal status.
- Pre-requisite tests for all women:
- Pelvic ultrasound (including transvaginal).
- Recent Cervical Screening Test (within five years).
- STI screen (Self obtained low vaginal swab pcr CT/NG).
- If heavy menstrual bleeding include FBE, Ferritin and TFT.
Urgent referrals
Gynaecology referrals for postmenopausal bleeding or abnormal uterine bleeding are triaged according to symptoms and menopausal status.
Direct specialist referrals may also be acceptable especially for more urgent cases such as postmenopausal bleeding with raised endometrial thickness on ultrasound or women with a history of breast cancer who are taking Tamoxifen.
Urgent referrals may be discussed with the Gynaecology On Call Registrar on (08) 6458 2222.
Referral process
All referrals from GPs to this clinic are sent to the Central Referral Service WA (CRS) (external site). Ensure you provide the relevant information in the referral to enable appropriate triage, including required investigation results and letters from treating medical practitioners if relevant and request outpatient hysteroscopy clinic at WNHS.
Referrals using GP software that include all the relevant history and information are also welcome using CRS referral form templates (external site).