April 2024News

New facility drastically cuts delays in assessing certain gynecological problems

Hysteroscopy suite allows some women to bypass operating room for diagnosis and treatment

By the fall of 2023, Sharon Côté was a self-described “nervous wreck”. Not only was she experiencing heavy vaginal bleeding despite being menopausal, the three ultrasound exams that she’d already undergone had not yielded consistent or conclusive results.

According to one of the ultrasounds, the 53-year-old Ms. Côté might have endometrial hyperplasia, a cancerous or pre-cancerous condition. Then again, she might not. As another of the ultrasounds seemed to indicate, it could it just be a fibroid or polyp.

“You can imagine the stress,” she recalls today, shaking her head. “Continuing to bleed was bad enough, but not knowing what was causing it made it so much worse.”

In the new hysteroscopy suite in Pavilion K, Dr. Samantha Benlolo (left) meets with Nurse Samantha Bascombe, who is Team Leader in the Operating Room for the Department of Obstetrics and Gynecology. (Click on photo to enlarge it.)

In the new hysteroscopy suite in Pavilion K, Dr. Samantha Benlolo (left) meets with Nurse Samantha Bascombe, who is Team Leader in the Operating Room for the Department of Obstetrics and Gynecology. (Click on photo to enlarge it.)

Even a hysteroscopy at the JGH was a less-than-ideal solution. During this procedure, a probe with a tiny camera at its tip is inserted, via the vagina and cervix, into the uterus, which can be examined visually in great detail.

The problem wasn’t the procedure itself, which promised—with great likelihood—to provide the answers Ms. Côté was so desperately seeking.

Rather, at that time, an operating room (OR) was the most appropriate place in the JGH to perform a hysteroscopy. But undergoing the procedure in an OR obligated the women to be categorized as surgery patients, even though the hysteroscopy usually lasts a mere 15 minutes and involves a minimal amount of actual surgery.

This meant the women had to be placed on the surgical waiting list and be subjected to as much as six months of nerve-wracking suspense before being called in for the test.

Ms. Côté briefly gave some thought to having the hysteroscopy in a private clinic, but this proved to be prohibitively expensive. That left her with no choice but to place her name on the surgical list—and wait and wait… “I had my phone on constantly,” she says, “because I thought the call might come at any moment.”

Then, in February of 2024, to Ms. Côté’s great relief, everything changed for the better.

Her obstetrician-gynecologist, Dr. Samantha Benlolo, had just succeeded in opening a suite in Pavilion K specifically designed and equipped for hysteroscopies. Since patients could now bypass the operating rooms, the waiting time for an exam was drastically reduced. (As an added benefit, the ORs are freed up for patients who needed actual surgery.)

Ms. Côté underwent her procedure on February 13 and was among the earliest patients to benefit from the streamlined process. Equally important, she was finally able to get the answer from Dr. Benlolo that she had been hoping for: the bleeding was almost certainly caused by a polyp and a fibroid.

” It felt good knowing I was being spared having to wait extra weeks or months for an answer.

Although these findings weren’t yet definitive (that would come later), Dr. Benlolo’s view of her patient’s endometrium led her to the preliminary conclusion that the problem was not related to cancer.

And then the news got even better: unexpectedly, a surgical slot opened up on February 22, enabling Ms. Côté to have the polyp and fibroid removed in an operating room—true surgery that was not possible in the hysteroscopy suite.

By mid-March, the bleeding hadn’t entirely stopped, but Ms. Côté was no longer concerned about the faint spotting that was soon expected to disappear.

For Dr. Benlolo, being able to make use of the hysteroscopy suite—which went into service on January 24—was the culmination of three years of painstaking planning and development that benefited significantly from the financial support of the JGH Foundation.

The suite is also closely aligned with “Care Everywhere”, the broad-based, patient-centred approach to care in CIUSSS West-Central Montreal. It states that the network’s goal is to strive for the best outcomes by providing patients with the right care at the right time in the location that is the safest, most appropriate and most convenient.

In this instance, the hysteroscopy suite is the most appropriate location for gaining an accurate understanding of why certain women are experiencing particular gynecological problems. Armed with this knowledge, physicians like Dr. Benlolo can administer the right care at the right time.

The suite can also be helpful in more situations than the one that Ms. Côté faced, Dr. Benlolo explains.

For example, it’s used for women who have abnormal bleeding (such as bleeding between periods, after intercourse or after menopause); for assessing fertility in a woman who wants to get pregnant; and for locating and extracting a retained intra-uterine device (IUD).

Dr. Benlolo also notes that not every woman is a suitable candidate for examination in the hysteroscopy suite.

JGH Foundation provided crucial support for the hysteroscopy suite

The hysteroscopy suite could not have been launched at the JGH without essential support from the JGH Foundation.

Donations can be made online to support any of the JGH’s programs and services.

Among the criteria is the patient’s motivation to undergo the procedure outside the OR, since she will receive only a pain-killer and not the sedation or general anesthetic that can be provided in an operating room.

In Ms. Côté’s case, the pain medication was purposely kept to a minimum during the hysteroscopy, because she wanted to watch the screen that displayed her own insides. “It’s not something you see every day,” she says with a laugh, “but I was fascinated to know what it looked like.”

Dr. Benlolo adds that, like Ms. Côté, some women will still need an operation, since the information that emerges from the hysteroscopy may lead the gynecologist to decide that surgical intervention—such as the removal of a growth—is necessary.

For Ms. Côté, the suite yielded more than medical data; it generated peace of mind. “I’ve always been quite healthy and haven’t needed to be in the medical system very much,” she says. “That’s why having the hysteroscopy felt very ominous to me at first.

“A lot of the credit goes to Dr. Benlolo and the nurse who assisted her for keeping me calm during the actual examination. But aside from that, it felt good knowing I was being spared having to wait extra weeks or months for an answer. At last, I knew where I stood.”

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