• Reference Number: HEY1135/2023
• Departments: Gynaecology
• Last Updated: 29 September 2023

Introduction

This leaflet has been produced to give you general information about your treatment. Most of your questions should be answered by this leaflet/booklet.  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 who has been caring for you.

What is a cervical ectropian?

Bleeding after sex and excessive vaginal discharge, are usually caused by a process which affects the cervix, which is called an ECTROPION or ECTOPY.

This is a normal occurrence in which the delicate cells that line the cervical canal spread onto the surface of the cervix and become exposed. The cervix appears red because the cells that line the cervical canal are thinner compared to the thicker cells that are on the outside of the cervix.

These delicate cells are more likely to bleed whilst having sex or whilst taking a smear test. The cells also produce mucus to lubricate the vagina. If these cells are exposed, you may notice an increase in discharge.

Cervical ectropion is related to the hormone oestrogen. It is common in young women and those taking the oral combined contraceptive pill.

Why do I need diathermy treatment to my cervix?

Before undertaking treatment, it is important to rule out infection, inflammation and the possibility of abnormality. This may include swabs and occasionally a biopsy may be taken from your cervix.

After investigations the ectropion may be treated if your symptoms are troublesome. A decision to treat your ectropion will depend on any tests that have been performed recently by your GP or any investigations performed in clinic.

You may decide that you do not wish to be treated. If so then the delicate skin on your cervix will gradually change into the thicker skin. The length of time for this to occur is unpredictable. You may therefore continue to have symptoms but can be reassured that you will come to no harm. It is important that you attend for your cervical sample when requested to do so.

What is diathermy treatment to the cervix?

Diathermy treatment of the cervix (also known as cervical cautery) involves removing the top layers of delicate cells from the cervix using a heated ball tipped probe. This treatment allows heathy, tougher cells to grow back.

This treatment is an outpatient procedure using local anaesthetic. The procedure takes about 5 – 10 minutes. All aspects of your treatment and follow-up will be discussed with you before your treatment.

Why do I need diathermy treatment?

Diathermy treatment to the area on the cervix promotes growth of the tougher, thicker tissue. This tougher tissue is less likely to bleed during sex or produce excessive vaginal discharge. It is a quick simple treatment method and it will not affect your future fertility.

Can there be any complications or risks?

The complication rate of this procedure is very low. The most common complication is narrowing (stenosis) to the opening to the cervix. There is also a small risk of infection which is easily treated with antibiotics from your GP.

How do I prepare for diathermy treatment?

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. There are no health risks with this procedure.

What if I am having a period when my appointment is due?

It may not be possible to perform the diathermy treatment if you are having a period and you may need to telephone to change your appointment. If this is the case the number to contact is (01482)624035/624031/607829.

What if I am pregnant?

It will not be possible to carry out diathermy treatment to your cervix if you are pregnant. Please contact (01482)624035/624031 to cancel your appointment.

What will happen?

You will be placed on a couch with your legs supported. An instrument called a speculum is inserted in the vagina so that your cervix can clearly be seen.

The diathermy procedure is usually done in the colposcopy clinic and usually takes about 5 – 10 minutes. You will be given a local anaesthetic so you will be awake, but you should not feel any pain. The local anaesthetic will sting a little, but the area will very quickly go numb. The local anaesthetic may also increase your heart rate. The side effects of the local anaesthetic will only last briefly and should not cause you any harm.

A heated ball tipped probe is used to remove the area cells on the cervix. The ball tipped probe is heated by an electric machine.  To ensure that the procedure is safe, a sticky pad is placed on your thigh. You may also hear a noise from the machine when the procedure is performed. 

You should not feel any pain during the procedure. If you feel pain, please inform the nurse who is with you. 

Following the treatment, you may feel period-type pain or a slight burning sensation. The pain should go away with pain relief such as paracetamol and ibuprofen. To prepare for the treatment, you might find it helpful to take simple pain relief such as paracetamol or ibuprofen about an hour before your appointment.

What happens afterwards?

You will be able to go home 15 minutes after the treatment if you feel able. You can drive a car or take public transport.

It is normal to experience a heavy watery discharge for the first few days. This watery discharge may last for up to 4 weeks. It may change from pink to brownish in colour. The discharge should not be yellow or foul smelling. If this occurs, you must see your GP who can prescribe you antibiotics.

In order to reduce the risk of infection during the first 4 weeks you must:

• Use sanitary towels and not tampons.
• Avoid sexual intercourse.
• Avoid swimming.
• Avoid vaginal creams.

You must contact your GP or the Gynaecology Department on (01482) 607829 if you have any of the following:

• A smelly discharge.
• Fever or high temperature.
• Heavy vaginal bleeding.
• Severe abdominal pain.

Will I need a follow up appointment?

It will be up to the clinician who treated you as to whether you need to be seen again in clinic. An appointment will be sent to you if required.

Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact:

Sarah Bolton/Charlie Fear Nurse Colposcopists – (01482) 382644

Gynaecology Outpatients Department, (Monday to Friday 8.00am – 5.00pm) – (01482) 607829

Cedar Ward (Gynaecology) –  (01482) 604387

Colposcopy Office, (Monday to Friday 9.00am – 5.00pm) – (01482) 624013/624035

NHS Direct www.nhsdirect.nhs.uk  – 08454647

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.