Gynaecology clinics and surgery

We understand that seeing a gynaecologist can be very stressful — especially the first time. The following information will give you an idea of what to expect and help you get the most out of your appointment.

• Visit our patient and visitors information before you come to one of our clinics — if you understand some of the basics, we can spend more time on the things important to you.

North Shore Hospital (internal link)

Waitākere Hospital (internal link)

• Write down your biggest aims in being seen and your biggest worries — it makes it easier to address these things during the first appointment.
• Be on time — factor in traffic and parking when you plan your day. We do our best to accommodate last-minute hiccups but sometimes have to cancel latecomers.
• Go to the right hospital — we have clinics at Waitakere Hospital and North Shore Hospital so double-check where your appointment is before you leave.
• Go to the right building — our clinics are not all in the same place.
• Bring your appointment letter with you, so you have the location, time and date handy
• Tell us if your mobile number changes — we want you to get our text reminders.

There is a lot to get through at your first appointment, and we want you to get what you need from us. It can really help to think through your medical history before you come so that it is clear in your head. Write down key dates and events if you cannot remember them.

The gynaecology clinic checklist contains the main questions you should have answered by the time you have been through our clinic process.

You may fill it out yourself during your clinic appointment or ask your hospital doctor to help you.

Gynaecology clinic checklist [PDF, 140 KB]

Your healthcare professional will want to understand:

• how your symptoms have developed
• how much these symptoms impact on you
• whether you have other medical or lifestyle conditions that might be important
• once they have a clear picture of what’s going on, they will usually wish to examine you.

Vaginal examination in the clinic

A vaginal examination is when your healthcare provider uses one hand's fingers to feel inside your vagina while pressing with the other hand on your lower abdomen.

You will have a sheet covering your lower body to help you feel less exposed.

• We understand it can make people feel very exposed and that there are some cultures where this area of the body is sacred or tapu.
• We also know that many people have experienced sexual trauma in their past, and having a vaginal examination can be confronting or distressing.
• We may do this in the clinic to help us make a diagnosis or to rule out a diagnosis. If you need surgery, this kind of examination can also help us decide what surgical options you have.
• We may also perform a speculum examination, using an instrument designed to fit in your vagina and help us see your cervix. This also allows us to do a cervical smear or take samples to test for infections.

Having a cervical sample taken (internal link)

Missing these parts of your clinic assessment can sometimes make it more challenging to make certain decisions.

We will not do this if it causes you great distress or have never been sexually active and do not want us to.

To help make your examination easier:

• tell us if vaginal examinations are difficult for you
• ask for a chaperone if you would like more support
• consider bringing a support person, such as someone from your family, friends or whānau
• wear clothes that are comfortable and easy — slip-on shoes and slip-on skirts or pants are good options.

In the lead up to your surgical date, you should:

• feel very comfortable with your surgical plan,
• understand the benefits and risks of your surgery,
• have been checked by the anaesthetic team,
• know what time to come to the hospital, where to go, and have a plan for who will bring you home and support you in your recovery.

There is a lot to consider, especially if this is your first surgery experience, but if you feel confused call the booking and scheduling team and ask for their advice.

You need a contact person

We ask you to give us the name and contact details of someone to call in the case of an emergency during your care.

It is a good idea to think about who this person will be and let them know that they have been named, as well as details about the timing of your surgery.

When to stop eating and drinking

It is important to stop:

• eating 6 hours before your operation
• drinking water up to 2 hours before your operation.

This is to protect your lungs when we get you off to sleep with a general anaesthetic. Any food or drink in your stomach can be inhaled at this time.

Make sure you try to eat and drink well before the 6-hour cut off, as it can make the day of your surgery much easier.

If you eat or drink something other than water within the 6 hours, your operation will usually have to be cancelled and rescheduled on another date.

Taking your regular medicine

As part of your anaesthetic plan, an anaesthetic doctor or nurse will tell you which of your regular medicines to continue and which to stop. These can be swallowed with a small amount of water before surgery.

Blood tests before your operation

If you need blood tests in the days before your surgery, our booking and scheduling team will tell you.

The most common things we test are:

• if your blood count (haemoglobin) is normal
• if you are pregnant
• what blood type you are in case we need to give you a blood transfusion during your operation.

If you have body parts removed

The parts of your body that we remove during surgery almost always need further testing to give you a final diagnosis.

You will be asked if you want to have any of these body parts returned to you once the lab has finished its testing. Your answer will be written on our hospital form on the day of your operation.

Because our tests involve a lot of work, the body parts returned to you may be in small pieces and usually take a week or more to be returned.

If you have surgery anxiety

If you have severe anxiety or panic attacks, it is a good idea to tell us in your health questionnaire so that the anaesthetic team can have a good plan on the day of your operation.

On the day of surgery, while you wait for the operation, we can give you a pre-med which treats anxiety, after all consent forms are signed.

If you are already on a waitlist and think you need a pre-med and this has not yet been addressed, call our booking and scheduling team.

You will be asked to sign a consent form on the day of surgery. For more information about what informed consent means is on our informed consent page.

Informed consent (internal link)

You can only give your informed consent if you feel you have been given enough information to understand:

• your medical condition
• the options available to you
• the risks and benefits of your different options.

Most of this information is given during your clinic appointments and cannot be covered in-depth on the day of surgery. On the day of surgery, the hospital doctors will:

• explain the risks of the operation and anaesthetic
• ask your permission for medical students to examine you
• ask your permission for any blood transfusions in case you have heavy bleeding
• ask whether you want any body parts returned to you.

Signing the consent form means that you:

• choose for us to perform the operation written on the consent form
• understand what the operation involves
• are comfortable with the risks involved.

Important suggestions

• Please consider these issues before the day of surgery and consider talking it through with friends and family, your healthcare provider, or your gynaecologist.
• Make sure you understand your gynaecological condition well enough.
• If you need more information to give informed consent, please contact our booking and scheduling staff to request another clinic appointment.

Gynaecology — Auckland (West and North) (internal link)

• If we are not meeting your needs because of cultural differences, we do have some cultural support services available.

North Shore Hospital (internal link)

Waitākere Hospital (internal link)

There are many different types of gynaecological surgery.

By the time the day of your surgery arrives, you should feel comfortable about what operation you will have, the specific risks of your operation, and what to expect during your recovery. If you have questions about your operation, contact our booking and scheduling team. If they are unable to answer your question, they can direct you to the right place for answers.

Gynaecology — Auckland (West and North) (internal link)

Gynaecology day of surgery pamphlet [PDF, 373 KB]

Gynaecological Surgery - Day of Surgery — Vimeo (external link)

Where and when your surgery will be

One of our booking and scheduling team will contact you when the date of your surgery is finalised. They will tell you where to go, what time to arrive, and what you need to do in the lead up to your operation.

Your operation may be at the North Shore Hospital Tower Block, Elective Surgery Centre (ESC) or at Waitakere Hospital.

North Shore Hospital (internal link)

Waitākere Hospital (internal link)

Who will be in your surgery

You will meet a lot of new people on the day of your operation. We work as a team, and everybody has an important part to play in your care. Being a teaching hospital means that we have trainee doctors, nurses and technicians working alongside us and learning on the job.

Trainee doctors or registrars are not the same as medical students. They are qualified doctors who are on the path to becoming specialists. Trainees in theatre may be assisting, operating or anaesthetising depending on how far through their training they are.

We often have medical students in the theatre. They are present as observers only unless you give specific consent for them to be more involved. If you hear the term trainee intern, that means a final year medical student.

We have prepared a pamphlet and video to explain this further.

Vaginal examination pamphlet [PDF, 382 KB]

Gynaecology - Vaginal Examination video — Vimeo (external link)

Our strength in treating you does not come from one person — it comes from excellent teamwork and passing on our knowledge to the next generation.

How your day will go

Before the operation — in the reception area

• You should arrive at the hospital with the personal items you will need during your stay. You should have been given a rough idea of how long you will be in the hospital.
• You can usually bring a support person with you, such as family, friends or whānau. If this changes, we will make sure you know ahead of time.
• Our reception staff will check you in and explain where to wait.
• You should know the details of the person you want us to call in case of emergency.

Before surgery — in the pre-operative area

• Nurses will take care of you and get you ready for the operation.
• Your blood pressure and pulse are checked.
• Final checklists are done.
• You may have final blood tests or extra treatments like enemas to empty your bowel.
• You will be asked to complete our consent forms.
• If there is something specific we want to teach our medical students (such as vaginal examination), you will be asked. You have the right to say no, and it will not affect your care in any way. Because this is a sensitive and very important area in gynaecology, we have prepared a separate pamphlet and video to explain this further (please refer to our surgical resources).
• Usually, your operation will happen within 2 to 4 hours of your arrival. But bring something to do in case it takes longer, for example, a book to read.

During surgery — in the operating theatre

• Making your operation happen safely commonly takes up to 10 healthcare professionals working together. Some may arrive in the operating theatre after you are asleep.
• Your anaesthetist will confirm your details again, and you will meet the anaesthetic technician who helps your anaesthetist.
• There will be 3 or 4 nurses who will help you get ready and then help with setting up for the operation.
• You will be asked to lie on your bed with your arms by your side. There will usually be special boards for you to rest your arms on, and a blanket to keep you warm.
• You will have an IV line placed in your arm or hand. The technician will put an oxygen monitor on your finger and a blood pressure cuff around your arm.
• Your anaesthetist will then get ready to start your anaesthetic.
• Your body will be covered until you are fully anaesthetised.
• Once you are asleep, you are uncovered and positioned.
• A final vaginal examination may be done so that your surgeon can plan the operation.
• You are then cleaned and covered with sterile surgical drapes.