'Like ripping my insides' - fears hysteroscopy guidelines not enough

Wendy McLean was due to start her seventh round of IVF when her doctor said she needed a hysteroscopy – a procedure to examine the inside of her uterus.

“It was sold to me as a smear test, basically. A thin narrow camera up through your cervix.

"It’ll take minutes. You won’t need pain relief. You’ll be absolutely fine,” she said.

Wendy, 38, took over-the-counter pain killers before the outpatient procedure at Aberdeen Royal Infirmary in case it was uncomfortable, but this did not prepare her for what happened.

“It felt like getting a hot poker, like getting my insides ripped out. I think I described it to somebody before as like being clawed, like sharp nails, just ripping at my insides.”

Wendy said she lost consciousness twice, vomited and asked for the procedure to be stopped.

It was only when searching online she discovered thousands of other women had had similar experiences of painful hysteroscopies without anaesthetic.

According to the Royal College of Obstetricians and Gynaecologists (RCOG), a third of those undergoing a hysteroscopy report pain levels of seven or above out of 10.

It says patients should be offered local or general anaesthesia for the procedure and their medical history should be taken into account, including trauma or difficulty with smear tests.

But despite RCOG producing new clinical guidelines promoting pain relief and choice, many women say they are not being offered it.

Dr Geeta Kumar, consultant gynaecologist and vice president of RCOG, said they had listened to patients’ concerns.

“Clear accurate written and verbal information must be provided, both at the time of referral, and at the procedure appointment,” she said.

“This will support a woman to make an informed choice, including whether they want to proceed with the procedure and if so, their preferences for treatment setting and pain relief options.”

Katharine Tylko, from the Campaign Against Painful Hysteroscopy, said: “It will have no impact whatsoever, apart from a few very conscientious and compassionate fighting-types of gynaecologist - young women who will say – ‘We want decent care for our patients.’

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Source: BBC News, 18 September 2024

Related reading on the hub:

• Improving hysteroscopy safety (Patient Safety Learning, November 2020)
• Painful hysteroscopy - Patient's share their experiences on our Community thread