Common gynaecological procedures:
what to expect
If you’ve been referred for a gynaecological procedure – whether it’s something straightforward here at Her Health Clinic or a day surgery at St John of God Murdoch Hospital; it can still feel a bit stressful. This guide explains the most common procedures I perform, so you have a clearer idea of what to expect and how it all works.
Murdoch Gynaecologist
In-clinic gynaecological
procedures
These procedures are done right here at Her Health Clinic – no hospital stay needed. They’re usually quick, low-risk, and you can head home soon afterwards.
Colposcopy
A colposcopy is a procedure that lets us take a closer look at the cervix using a special instrument called a colposcope – it’s a magnifying glass with a light, and it stays outside the body. The speculum is the instrument that we use to visualise the cervix.
You might be referred for a colposcopy after an abnormal cervical screening (previously called a Pap smear) result. This doesn’t mean you have cancer – in fact, a lot of abnormal results are due to minor cell changes that often clear up on their own. The colposcopy simply helps us see those changes more clearly and decide if any treatment is needed.
The procedure feels similar to a cervical screening test, but takes a little bit longer as it is a comprehensive look.
If we see anything that needs further investigating, we may take a small biopsy. You might feel a brief cramp or localised pain at that point, but it’s over quickly, unfortunately due to different pain thresholds, women may sometimes be quite uncomfortable during the procedure. If that is the case, we will discuss more options to complete the colposcopy.
You can usually carry on with your day afterwards, though I always suggest taking it easy for the rest of the day. I also advise women to take some ibuprofen and paracetamol before arriving and after leaving.
Dr Eman Alnaggar
Murdoch Gynaecologist
Having a colposcopy
IUD insertion or removal
An IUD (intrauterine device) is a small, T-shaped device placed inside the uterus to prevent pregnancy or treat heavy bleeding. It’s a very effective, low-maintenance form of contraception that can last between 5 to 10 years, depending on the type.
There are two main options:
- Hormonal IUDs (like Mirena/Kyleena), which release a small amount of hormone to prevent pregnancy by thickening the cervical mucus (so sperm can’t reach the egg), thinning the lining of the uterus, and sometimes stopping ovulation. They’re over 97% effective and often make periods lighter or stop altogether.
- Non-hormonal IUDs (like the copper IUD), not available in many options of devices in Australia, which use copper to create an environment that’s toxic to sperm – stopping them from reaching and fertilising an egg. This option is also over 97% effective and hormone-free. It does cause an inflammatory effect in the uterus and usually causes heavy menstrual bleeding, which may not be for you. We can discuss this further in a consultation.
IUD insertion is done here at Her Health Clinic in Murdoch, and usually takes about 10- 20 minutes. It can feel crampy – a bit like a strong period pain – especially during and just after the procedure. I often recommend taking some pain relief beforehand, and we’ll talk through ways to make the process as comfortable as possible.
Afterwards, some spotting or cramping is normal for a few days. Most women are fine to return to work or normal activities the same day, but it’s always okay to take it slow.
If you’re having an IUD removed, it’s usually a quick and simple process- it feels like a quick cramp and it’s over. Sometimes it’s more complicated, but let’s cross that bridge if we need to.
An IUD isn’t right for everyone, so we’ll always have a consultation beforehand to make sure it suits your needs, lifestyle, and preferences.
Endometrial biopsy
An endometrial biopsy is a simple test where we take a small sample of the lining of the uterus (called the endometrium). It’s usually done to investigate unusual bleeding – such as heavy periods, bleeding between cycles, or bleeding after menopause.
The procedure is done here at Her Health Clinic and only takes a few minutes. A thin, flexible instrument is gently passed through the cervix, called a pipelle, to collect the sample. It’s a bit like a cervical screening test, but you may feel a short, sharp cramp as we take the biopsy. This is part of the examination and passes quickly.
Afterwards, you might have some spotting or mild cramping for a day or so. Most women recover well with no special aftercare needed – just a bit of rest and some pain relief if needed.
The sample is sent to the lab and I’ll follow up with your results once they’re back. If we find anything unusual, we’ll go through the next steps together so you can be very clear about your plan of care.
Not all cases are suitable to have a biopsy in the office, so this needs to be discussed before proceeding. Many times we need to look at the uterine cavity with a camera, which is done as an inpatient.
In-patient gynaecological
procedures
Some procedures need to be done in hospital, either because they require anaesthetic or specialised equipment. These are usually performed as day surgeries, meaning you’ll be able to go home the same day and recover comfortably at home.
Hysteroscopy dilatation and curettage
Hysteroscopy dilatation
If you’ve had an endometrial biopsy but we still need more information – or your symptoms are continuing – the next step may be a hysteroscopy.
You might be referred for a hysteroscopy if you’ve had heavy or irregular bleeding, bleeding after menopause, or following a miscarriage that was incomplete. It can also be done to help diagnose the cause of abnormal bleeding if other tests haven’t given us enough information.
A Dilation is only done if we cannot access the uterine cavity with the camera alone, but after every hysteroscopy a curettage is done.
While a biopsy gives us a small sample from the lining of the uterus, a hysteroscopy allows us to actually see inside the uterus using a thin telescope-like camera. It can help us find things like polyps, fibroids, scarring, or anything unusual that we wouldn’t pick up from a biopsy alone.
The procedure is done in hospital under a light general anaesthetic. The camera is passed gently through the cervix – so there are no cuts or stitches. If needed, we can take a biopsy or remove polyps or fibroids at the same time. It’s a day procedure, so you’ll be able to go home later that day.
Afterwards, it’s normal to have some mild cramping or light bleeding for a day or two. Most women recover quickly and are back to usual activities within a couple of days.
If we find anything that needs treatment or follow-up, I’ll explain everything clearly and we’ll make a plan together that feels right for you.
Dilation and curettage (D&C) without a hysteroscopy.
A D&C is a procedure used to remove tissue from the inside of the uterus.
The procedure is done in hospital under a light general anaesthetic. The cervix is gently opened (that’s the dilation part), and a small instrument is used to remove or sample the uterine lining (the curettage). There are no cuts or stitches involved, and it’s usually finished in under 20 minutes.
It’s a day procedure at SJOG Murdoch Hospital, so you’ll be able to go home the same day once you’ve had time to rest and recover. Afterwards, it’s common to have some cramping and light bleeding for a few days.
Dr Eman Alnaggar
Murdoch Gynaecologist
If it was done following a miscarriage, it’s okay to take some time – physically and emotionally. You’re not expected to bounce back straight away. Support and follow-up are always part of the care we offer.
Laparoscopy
Laparoscopy is a type of keyhole surgery (minimally invasive surgery) that allows us to look inside the pelvis using a thin camera inserted through a small cut near the belly button. It’s a common way to diagnose and treat a variety of gynaecological conditions.
You might be referred for a laparoscopy if you’re experiencing pelvic pain, suspected endometriosis, unexplained fertility issues, or if a cyst has been found on your ovary. In some cases, it’s used to remove scar tissue, cysts, or sometimes the ovaries or fallopian tubes if needed. Laparoscopy can also be used to remove your uterus (hysterectomy).
The procedure is done in hospital under general anaesthetic. A few small incisions are made (usually around 0.5–1cm), fill the tummy with gas, specifically CO2 to create space, and carefully examine the uterus, ovaries, and surrounding organs. If needed, we can treat or remove problem areas during the same procedure.
Most women go home the same day or the next morning. You might feel cramping, bloating, or shoulder-tip pain from the gas used during surgery – this usually settles within a few days. Recovery time varies depending on what was done, but many women feel back to normal within a week or so if they have had operative treatment but a few days if it was just a look.
We’ll go through everything beforehand so you know exactly what to expect, and we’ll follow up afterwards to make sure you’re recovering well and have everything you need.
Ovarian cystectomy
An ovarian cystectomy is surgery to remove a cyst from the ovary, while leaving the ovary itself intact. It’s often recommended if a cyst is large, persistent, causing pain, or has uncertain features on imaging. In many cases, cysts are benign and harmless, but when they start interfering with your quality of life or raise concerns, removal might be the best option.
There are two main ways we can perform an ovarian cystectomy:
- Laparoscopic ovarian cystectomy
This is the most common approach. It’s done through a few small cuts on the tummy using a camera and fine surgical tools. The cyst is carefully removed while preserving as much healthy ovarian tissue as possible. Recovery is usually quicker with less pain and scarring, and most women go home the same day or after an overnight stay. - Open ovarian cystectomy
Sometimes, an open procedure is needed – for example, if the cyst is very large, deeply attached, or there’s concern about possible cancer. In this case, a larger incision is made along the lower abdomen to allow better access. Recovery is a bit longer, but we’ll guide you through it and make sure you’re well supported.
We’ll always talk through the reasons for the recommended approach, and help you feel informed and confident before moving ahead.
Hysterectomy
A hysterectomy is the surgical removal of the uterus, and sometimes the cervix, fallopian tubes or ovaries. It may be recommended if you’re dealing with ongoing heavy bleeding, fibroids, endometriosis, chronic pelvic pain or if other treatments haven’t worked.
Being told you might need a hysterectomy can bring up all sorts of feelings. Relief, uncertainty, even a bit of grief. It’s a big decision and not one most women come to lightly. If it’s something we’re considering together, we’ll take the time to talk through what it means for you, both medically and emotionally.
There are a few different ways the surgery can be done, and we’ll recommend the approach that best suits your body and your situation:
- Laparoscopic hysterectomy
This is the most common approach. Several small cuts are made on the tummy, usually less than 1cm in size, so we can insert a camera and surgical instruments. The uterus is gently separated and removed through the vagina, and the top of the vaginal canal is then closed with dissolvable stitches. Because it’s minimally invasive, recovery tends to be quicker, and women often experience less pain and a shorter hospital stay. - Abdominal hysterectomy
This is a more traditional approach, done through a single larger cut on the lower abdomen. The incision is usually along the bikini line, but in some cases where the uterus is very enlarged, it may need to go vertically from the pubic area toward the belly button. This option might be recommended if laparoscopic or vaginal surgery isn’t possible or safe. - Vaginal hysterectomy
With this approach, the uterus is removed entirely through the vagina, without any external cuts to the abdomen. It’s often used when there’s a degree of pelvic organ prolapse, especially if a vaginal repair is needed at the same time. Recovery is usually quite smooth, and hospital stay is typically short.
Recovery varies depending on the type of surgery, but in most cases you’ll spend one to two nights at Murdoch hospital and need a few weeks to rest and heal properly. Even with a keyhole approach, it’s still a major operation, so allowing your body the time it needs is important.
The thought of a hysterectomy can feel overwhelming, but for many women it brings real relief. No more pain. No more heavy, exhausting bleeding. Just the chance to feel like yourself again.
You can read more about laparoscopic hysterectomy from Gold Coast Health here.
