Gynaecology - MyoSure Hysteroscopic Polypectomy

Your doctor has suggested that you undergo this procedure to remove your endometrial polyp.

This leaflet informs you about the MyoSure hysteroscopic polypectomy, which is a procedure to remove small lumps, such as fibroids and polyps, from the inside of the womb (uterus), the benefits and risks, and the available alternatives, to help you to make a fully informed decision.

What is the MyoSure Hysteroscopic Polypectomy procedure?

This is a brief procedure performed under local anaesthetic. A small telescope (hysteroscope) is passed into the uterus (womb) through the vagina and the polyp is then removed.

The procedure usually takes between 15 and 20 minutes depending on the size of the polyp. It does not involve any cuts and is done in the outpatient hysteroscopy department. You will have a local anaesthetic and so are awake throughout the procedure.

Why do we remove the polyps or fibroids?

Polyps and Fibroids can be associated with the following:

• Heavy periods
• Irregular periods
• Prolonged periods
• Bleeding in between your periods
• Vaginal bleeding after the menopause

We also remove polyps to ensure there is no cancer or pre-cancer within the polyp.

What are the risks?

As with all surgical procedures, there are risks associated with the MyoSure procedure. Side effects and risks that you need to be aware of are:

• Pain or cramping during the procedure
• Feeling sick, dizzy or feeling faint
• Vaginal bleeding or spotting after the procedure
• Infection of the womb, causing vaginal discharge and pain, or of the bladder (a ‘water’ infection) causing cystitis symptoms. Antibiotic treatment is usually needed
• Failure to gain entry into the uterus to remove the polyp, or failure to remove the polyp after entering the uterus
• Creating a small hole in the wall of the womb. This is called a perforation
• On rare occasions there can be damage to organs around the womb requiring further surgery like laparotomy or laparoscopy

What are the benefits?

• It is performed under local anaesthetic in the outpatient setting
• It avoids the need for a general anaesthetic (going to sleep) and the nausea and tiredness associated with this
• You can watch the procedure as it is done
• You can eat and drink as normal before the procedure
• There is no cutting or visible scarring
• The procedure is quick around 15 – 20 minutes in total
• Recovery is fast, with most women able to go home between 20 minutes and 2 hours after procedure 
• There is a rapid return to normal activities within 1 – 2 days of the procedure
• No hormones are involved
• Fewer hospital visits are needed compared to a general anaesthetic procedure

What are the available alternatives to remove a polyp?

• Hysteroscopic resection - This involves removal of the lining of the womb with a special camera and diathermy device. It is performed while you are under a general anaesthetic (so that you are not awake) and takes around 45 minutes. You need to have a ‘pre-op’ appointment before the operation, nothing to eat from the night before the operation, and to stay in hospital for around three hours after the procedure
• Do nothing

What if I am due for a period or have one as I am to attend my appointment?

There is no need to cancel the appointment if you have a period, you should still attend.

What can you expect when you decide to have MyoSure?

Day of the procedure

You can eat and drink as usual before the procedure. You will be given an appointment time to come to the Gynaecology Endoscopy Unit at the Royal Oldham Hospital.

Please bring an early morning sample of urine in a sterile container if you are of childbearing age. This is because we routinely do a pregnancy test before performing the procedure.

The doctor doing the procedure will see you before to answer any questions and check your consent form. To help ease the discomfort, you are advised to take 1000 mg paracetamol or 400 mg ibuprofen (if you are not allergic to these medications), which should be taken around 1 hour before the scheduled appointment. Please bring a sanitary towel with you to use afterwards.

A nurse will accompany you to the clinic, where you will be asked to remove your lower underwear and change into a gown. You will sit on a gynaecological couch with supports for your legs, with a sheet covering you.

There are usually two nurses present in the clinic. Sometimes another doctor or medical student may be present. The doctor will perform the MyoSure procedure and one of the nurses will support you throughout. It takes only about 15 to 20 minutes. If you want to, you can look at the TV screen to watch the procedure.

You will then be accompanied to a recovery area and offered a drink and further pain relief if you need it. Let the nursing staff know when you feel ready to go home – usually after 20 minutes but some patients may require a little longer. We advise you not to drive home yourself.

After the procedure

You can go home whenever you feel you are ready although you may want to rest at home for the remainder of the day. You may experience some watery and bloodstained discharge and discomfort which may go on for a couple of days.

You can have Ibuprofen 400mg oral and Paracetamol 1g oral 4 hours following the procedure or 6 to 8 hours after your first dose.
To reduce the risk of infection it is advisable to use sanitary towels at this time and not to use tampons until your next normal period. You should be able to resume your normal activities and/or work the following day.

Important Notes

• If you are of child bearing age, you must use contraception at least from the start of your period. A pregnancy test will be undertaken prior to the procedure
• You cannot have this procedure if you are, or think you may be pregnant or if you were pregnant in the last 6 weeks prior to the procedure
• Tell us of any symptoms that may suggest an infection, i.e. smelly discharge, continuing pain, feeling unwell/feverish

Any further questions?

If you have any questions or concerns regarding your condition or treatment, please ring 0161 627 8311 or 0161 656 1584

Useful Contact Telephone Numbers

The Royal Oldham Hospital
Gynaecology Endoscopy Unit - 0161 627 8076
Out of Hours Gynaecology Assessment Unit: Oldham - 0161 627 8855