Gynaecological services

Where answers matter most
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Our dedicated scans provide a thorough assessment of your pelvic organs and structures, encompassing the uterus, cervix, vagina, and fallopian tubes.
As a fundamental and primary diagnostic tool, a gynaecological ultrasound plays a vital role in detecting and investigating various gynaecological conditions, ensuring comprehensive care and peace of mind.

Gynaecology means the study and treatment of pelvic disorders in women who are not pregnant.

Ultrasound uses high frequency pulsed sound waves to produce images. Gynaecological ultrasound examinations usually involve both an abdominal and a vaginal approach to give us the best view of your pelvic organs.
Gynaecology
Gynaecological ultrasound examinations
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Transabdominal Scan

Transabdominal Scan

An ultrasound probe is placed on the lower abdomen. The uterus and ovaries can most often be seen, as well as any large pelvic masses or free fluid.
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Transvaginal

Transvaginal Scan

With an empty bladder, a small ultrasound probe, covered by a disposable protective sheath, is inserted gently into the vagina, either by the patient or by the sonographer. This method of scanning allows for better resolution images of the uterus, cervix, fallopian tubes and ovaries.
The transvaginal scan delivers higher quality results from a medical perspective. However, we understand that it is an intimate procedure. We seek to make you as comfortable as possible and we always treat you with great respect and care. And, if you prefer to have a transabdominal ultrasound only, we always respect your decision.

Our Gynaecology Servces

A gynaecological ultrasound is an ultrasound scan of the (female) pelvis, focused mainly on the uterus and ovaries, although other structures are often seen and may be included in the assessment.

Your doctor may refer you for a gynaecological ultrasound for one of these common indications:

  • Period or pelvic pain
  • intermenstrual or heavy menstrual bleeding
  • irregular or absent periods
  • difficulty conceiving
  • suspected ovarian cyst, pelvic mass or fibroids
  • postmenopausal bleeding or screening for ovarian cancer
Trans vaginal Ultrasound

Vaginal ultrasound provides much clearer views and more detail of the pelvic structures. A narrow, gel covered probe is gently introduced into the vagina. The examination takes approximately 10-20 minutes.

Transabdominal Ultrasound

In young girls, women who have not been sexually active or women who don’t feel comfortable having a vaginal ultrasound, a transabdominal ultrasound, or ultrasound through the abdomen can be performed. A very full bladder is necessary for the scan to be diagnostic.

What is endometriosis?

Endometriosis is an often painful condition that can affect your fertility and quality of life.

Tissue that normally lines the inside of your uterus (the endometrium) grows outside of your uterus. This mainly happens on the wall of the pelvis, on the ligaments supporting the uterus and on the ovaries. Sometimes, it can also grow around your appendix, bowel, or bladder.

Like the endometrium inside the uterus, the endometrial implants swell and then bleed with your monthly hormonal cycle. Your body responds by surrounding the affected area with scar tissue (adhesions). This can result in damage to pelvic structures and may cause them to stick together. Over time, the endometrial tissue may also enlarge and form cysts, particularly in the ovaries.

Symptoms include pain during periods and with sexual intercourse. Some patients experience pain with ovulation, urination or defaecation with periods. Other patients present with abnormal bleeding or infertility.

Endometriosis Assessment with Transvaginal Ultrasound

While superficial lesions of endometriosis cannot be reliably diagnosed with ultrasound, deep infiltrating endometriosis usually causes more distortion of normal anatomy in your pelvis. It can infiltrate into ligaments, bowel and bladder forming nodules and adhesions which can often be detected with transvaginal ultrasound.

A comprehensive transvaginal scan is performed, and results will be discussed with you either during or immediately after the scan by one of our specialists, and a detailed report will be provided to your doctor.

Endometriosis Assessment with MRI

A magnetic resonance imaging (MRI) scan can detect endometriosis sites deep within your pelvis, which can be difficult to see with ultrasound alone. Identifying and mapping these sites enables your doctors to develop a surgical plan to remove them and relieve your symptoms.

Saline Infusion Sonography

Saline Infusion Sonography (SIS) is an ultrasound-guided technique designed to better image the uterine cavity. A thin catheter is introduced carefully through the cervix and a small amount of sterile saline is injected through the catheter to allow for more accurate assessment of the uterine cavity.

Hysterosalpingo-contrast-sonography (HyCoSy)

HyCoSy is a transvaginal ultrasound technique used in the investigation of infertility. Its primary aim is to establish whether or not the woman’s fallopian tubes are patent or whether one or both is blocked.

The technique involves introducing an ultrasound contrast agent (Ex Em Foam) injected into the uterine cavity, which is then observed as it flows through the fallopian tubes to assess tubal patency. The contrast generates bright echoes that make visualisation of the tubes easier.
HyCoSy has increasingly been used as a first line investigation for infertility because it is convenient and safe.

A sterile speculum is placed in the vagina, and a thin catheter is then inserted into the uterine cavity through the cervical canal. The speculum is then replaced by a transvaginal ultrasound probe. The bright echoes generated by the contrast enable us to visualise the fallopian tubes and determine if there are any blockages along the way, the image is further improved by the addition of colour Doppler imaging. We use a normal sterile saline first to check for any issues (SIS), before using the ExEm foam contrast.

The test is performed from Day 7 to 10 of your typical menstrual cycle, to make the uterine lining easier to assess and to ensure there is no risk of a potential pregnancy.

Abnormal uterine bleeding
  • Excessive, prolonged or irregular bleeding that’s not related to your periods (e.g. bleeding between your periods, after sex)
  • Long, heavy periods.

It does not refer to bleeding in pregnancy, which is likely to have a different cause and need a different response.

There are many potential causes of abnormal uterine bleeding, including:

  • Hormonal imbalances – eg. thyroid conditions or polycystic ovary syndrome
  • Ovulatory and endometrial dysfunction
  • Changes in your uterus – eg. polyps, fibroids or adenomyosis
  • Cancer or precancerous conditions
  • Medications like hormone replacement therapy or contraception
  • Other conditions, including pelvic inflammatory disease.
Postmenopausal bleeding

Bleeding or spotting that occurs after you have stopped having menstrual periods.

Common causes include inflammation and thinning of the lining of the vagina (atrophic vaginitis) and growths in the uterus or cervix (polyps) which are usually benign.

The bleeding may be due to endometrial cancer in a very small number of cases which is why it is important not to ignore it. Transvaginal ultrasound is a very effective way to look for any polyps or areas of thickening in the uterine lining (endometrium).

Implanon is a small plastic rod containing the hormone progestogen that is inserted just under the skin of the upper inner arm. It provides protection against pregnancy for 3 years if left in place.

If inserted correctly, most Implanon devices can be felt just under the skin surface and are easily removed by the gynaecologist or GP in their practice. Occasionally the implant will have been inadvertently inserted deeper into the tissues of the upper arm, or is no longer Palpable. In these circumstances, an ultrasound-guided technique is necessary for removal.

To remove the implant, a small amount of local anaesthetic is inserted just underneath the implant and a small incision is made in the skin. The device is then removed through this incision in the skin. This leaves a small wound on the skin, which is closed with a suture and/or steri-strips. A waterproof dressing and compression bandage is then applied to the arm.