Examination Under Anaesthetic For A Suspected Gynaecological Cancer

  • Reference Number: HEY-598/2014
  • Departments: Gynaecology

Introduction

This leaflet has been produced to give you general information about your procedure.  Most of your questions should be answered by this leaflet.  It is not intended to replace the discussion between you and your doctor, but may act as a starting point for discussion.   If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team caring for you.

What is an examination under anaesthetic (EUA)?

Whilst you are asleep, during the anaesthetic, the doctor will be able to examine you more thoroughly. The examination depends on where your suspected cancer is but may include:

  • The use a speculum (instrument used during a routine smear test) to examine the neck of womb (cervix).
  • Manual examination by inserting a finger into your vagina and rectum (back passage).
  • Examination of your vulva (the outside genitalia).
  • A small piece of the suspected cancer may be removed and sent to a laboratory for further tests (a biopsy).
  • You may also have a cystoscopy and/or a hysteroscopy if appropriate.

What is a cystoscopy?

Cystoscopy is when under general anaesthetic, a small telescope (about 5mm or half a centimetre wide) is inserted into your urethra (the tube which drains urine from the bladder when you go to the toilet). Your bladder is then filled with fluid and the surface is examined using a light on the end of the telescope. Your consultant will then look for anything unusual. Before you were put to sleep you will have been consented to remove samples for further investigation, if this is needed.

What is a hysteroscopy?

Hysteroscopy is when under general anaesthetic, a small telescope is inserted into your vagina, through your cervix (neck of womb) and into your womb. Your womb is then filled with a small amount of gas or fluid and the surface lining is examined using a light on the end of the telescope. Your consultant will then look for anything unusual, take tissue samples (biopsy) or they may take a scraping of the lining of the womb, with an instrument called a curette. This procedure is called curettage. The sample taken is then sent to a laboratory and studied in detail to find out more about your suspected cancer.

Why do I need examination under anaesthetic (EUA)?

If a definite diagnosis has not been confirmed, your doctor will need to perform an examination under anaesthetic (EUA) and possibly take a sample of tissue (biopsy) in order to achieve an accurate diagnosis.

If you have already had a diagnosis of cancer these investigations will give your medical team a much better understanding of the type and size of the cancer and will help them to plan the best possible treatment for you – whether surgery, radiotherapy or chemotherapy, or perhaps some combination of these, are best for you. Your consultant will discuss this with you after the tests and will be happy to answer any questions that you may have.

Can there be any complications or risks?

Every care is taken to ensure that you are as safe as possible, and the majority of patients do not experience any problems. However any procedure involving a general anaesthetic has some risks.

  • Infection is possible and could occur in your pelvis, bladder or chest. If this does happen, it would need treating with antibiotics.
  • Bleeding following the operation is also possible, and in serious cases a blood transfusion and possibly another operation could be required.
  • Vaginal spotting of blood for a few days after the procedure is normal.
  • Bladder damage – there is also a small risk of damage to the bladder and/or womb, including a puncture. If this did occur a further operation could be required.

If you have any concerns about any risks then please discuss it further with a member of the medical team.

How do I prepare for the EUA?

Please read the information leaflet. Share the information it contains with your partner and family (if you wish) so that they can be of help and support. There may be information they need to know, especially if they are taking care of you following this examination.

It is important that you bring in all your medicines when coming into the ward. If you have any questions at all, please ask your doctor or nurse. It may help to write down questions as you think of them so that you have them ready. It may also help to bring someone with you when you attend your outpatient appointments.

What will happen?

You will be given an admission letter at your outpatients’ appointment this will give you the information on:

  • Where to go (which ward).
  • What time to attend.
  • When to fast (stop eating and drinking).
  • What to bring with you.
  • When to stop taking your medicines.

What happens afterwards?

When the operation is over you will wake up and be taken to the recovery area. A nurse will stay with you until you are fully awake. When you are awake you will be taken to the ward where you may rest until you have fully recovered. (You will probably feel quite drowsy for several hours).

Most patients feel well enough to go home on the same day as the investigation. However you will still be influenced by the anaesthetic and should not drive or sign any legal documents for 24 hours. It is likely that you will have a small amount of vaginal bleeding for up to three days following the procedure. If this happens, or if you begin your period, you should use sanitary pads and not tampons (to minimise the risks of infection).

You should find you are able to resume your normal activities the next day, including going back to work. However any concerns you have should be discussed with your GP or the hospital staff.

Useful contacts

Should you require further advice:

The Gynaecology Clinical Nurse Specialists are happy to speak to you at any time. If they are not there an answer phone is available on (01482) 624033.

If you need to speak to someone urgently, the staff on the Ward where you have had care will be happy to help.

Women’s Health Outpatients, Castle Hill Hospital – (01482) 624045.

Ward 14, Castle Hill Hospital – (01482) 623014.

Gynaecology Outpatients, Women and Children’s Hospital – (01482) 607829.

Information on Gynaecology Services at Hull and East Yorkshire Hospitals NHS Trust: www.hey.nhs.uk/gynaecology.

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

  • you must be able to give your consent
  • you must be given enough information to enable you to make a decision
  • you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.