Pelvic examination under anaesthetic

This is an internal examination under general anaesthetic . An examination under general anaesthetic is also called an EUA.

The examination includes checking your:

• cervix, vagina and vulva
• womb
• bladder
• anus
• rectum (back passage)

Your doctor (gynaecological oncologist) can take biopsies during the test if necessary.

Why you might have a pelvic examination under anaesthetic

You might have this examination to check for signs of cancer. It can help your doctor diagnose a number of cancers such as:

Preparing for a pelvic examination under anaesthetic

You see a doctor before your test. They will explain the procedure and ask you to sign a consent form. This is a good time to ask questions.

You might have a pre operative assessment appointment before your EUA. Or you might have a health questionnaire to fill in. Your healthcare team make sure you are well enough to have the anaesthetic and give you information on how to prepare for your test.

You won’t be able to eat or drink for several hours before your test. Your healthcare team will tell you exactly when you should stop eating and drinking. Your appointment letter will also have information about this.

Tell your doctor or nurse if not eating might be a problem for you, for example, if you have diabetes.

Let them know if you're taking medicines that change how your blood clots. This includes:

• aspirin
• clopidogrel
• arthritis medicines
• warfarin or heparin
• apixaban or rivaroxaban

You might need to stop taking this type of medicine a number of days before your EUA. Your doctor or nurse will tell you when you should stop. They will also tell you if you need to stop taking other medicines. 

As you are having an anaesthetic you will also meet your anaesthetist. They look after you while you are asleep.

You may need an empty bowel so your doctor can check the inside of your rectum. Your nurse may give you an enema  to clear your bowel before the test.

What happens?

When you arrive, a nurse will check your weight, blood pressure, temperature, heart and breathing rate. And will prepare you for your anaesthetic and procedure. This includes changing into a hospital gown and taking off any jewellery (except for a wedding ring).

When it's time for your procedure, your nurse takes you to the operating theatre.  

You have an anaesthetic so that you can’t feel anything during the procedure. You have this in the anaesthetic room, next to the operating theatre.

The anaesthetist puts a small tube called a cannula into a vein in your arm. You have any fluids and medicines you need through the cannula, including the general anaesthetic. This sends you into a deep sleep. When you wake up, the procedure will be over.

During the test 

While you are asleep, your doctor puts a speculum into your vagina to keep it open. They check your cervix and vagina for signs of cancer.

They pass a slim telescope, called a hysteroscope, through your cervix into the womb. They then put some fluid or gas through the hysteroscope to slightly inflate your womb. This makes it easier for them to see inside and carefully examine your womb.

To check your bladder, they put a thin tube with a light and camera attached (called a cystoscope) into your urethra. The urethra is the tube that drains urine out of your body from the bladder. They fill the bladder with sterile fluid and carefully check the bladder.

Your doctor uses their gloved finger to feel for any growths inside of your rectum. Or they might use a proctoscope or sigmoidoscope to look inside your bowel.

Your doctor takes biopsies of any abnormal areas. They send these to the lab to check for cancer cells.

After your examination

You wake up in the recovery room, where you are looked after by a nurse until you wake up properly from the anaesthetic. Once you're awake you go to the ward to recover. Your nurse will continue to check and monitor you on the ward. 

You might have some mild pain after the test. Let your nurse know if you have any pain. They can give you painkillers to help.

You need to be in hospital for at least a few hours after a general anaesthetic. You usually go home the same day.  As you've had an anaesthetic you’ll need someone with you. This is so they can take you home and stay with you overnight. For 24 hours after having a general anaesthetic you shouldn’t:

• drive
• drink alcohol
• operate heavy machinery
• sign any legally binding documents

You might have some light vaginal bleeding or spotting for a few days after a biopsy. You should use sanitary pads during this time. Also during this time, you should avoid using tampons and having sex. This helps to reduce the risk of bleeding and infection.

Possible risks

A pelvic examination under general anaesthetic is a safe procedure. Your nurse will tell you who to contact if you have any problems after your test. Your doctor makes sure the benefits of this examination outweigh any possible risks. 

Infection

There is a risk of getting an infection in your pelvis or bladder, or your chest (from the general anaesthetic). Signs of an infection include a high temperature or fever and feeling generally unwell.  Contact your hospital 24 hour advice line if you have symptoms of an infection.

Before you go home, your nurse will give you information on what to look for and who to contact if you are concerned you might have an infection.

Bleeding

There is a small risk of heavy bleeding after this test. In severe cases, you might need a blood transfusion or an operation. 

Damage to your bladder or womb

During the test, there is a small risk of injury to the bladder or womb. If this happens, you might need another operation.

Pain and discomfort

You may have some pain or discomfort after this test. This can include period type pain or tummy cramps. Or you might have pain when you pee. Your nurse will let you know what you can take to help relieve the pain. 

Getting your results

You should get your results within 1 or 2 weeks. You normally get them at your next clinic appointment.

Waiting for test results can be worrying. You might have contact details for a specialist cancer nurse. You can get in touch with them for information and support if you need to. It may help to talk to a close friend or relative about how you feel.

More information

We have more information on tests, treatment and support if you have been diagnosed with cancer.