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Painful hysteroscopy

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17 hours ago, Kathy Nabbie said:

It's great the hospitals are highlighted in the link- In one story the patient did not know the people in the room- This is poor  practice! Everyone in the room should be introduced to the patient- This is part of protocol and if not followed, is  also disrespectful.

I didn't even know who my Dr was ! I believed it was the consultant named on my letter, I think he wanted to remain anonymous, I only found out who he was when my GP printed off his letter which even had someone else's medical history on, because he failed to take my relevant history. There was a nurses to assist the Dr ,+2 HCA busy chatting at the door which was in full view, a junior Dr being taught that you don't need informed consent and it's fine to inflict pain on unsuspecting women. Not one introduced themselves. There was the absolute minimum of conversation. All this with incomplete screens and left uncovered and alone for about 10 minuets. I was treat like a piece of meat. No respect at all.

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I can’t have a GA because of my weight. I probably could have an epidural without it being dangerous for me. The problem is I can’t see me ever being able to trust anyone to perform that kind of procedure on me ever again. I was basically tortured by nice people. I feel let down by them, by my consultant, who chose to gloss over my horrible experience and make a joke about my weight instead. I also feel let down by the NHS because I am a woman who obviously doesn’t matter. The word ‘tolerate’ belongs in a Jane Austen novel not in the vocabulary of someone performing gynaecological procedures on vulnerable patients. 

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i would like to say the NHS was sold outpatient hysteroscopy as easy mainly by Italians the problem is it is not it is extremely skilled and needs decades of experience to be really good at it one gynecologist from Spain  has %5 failure rate and stops at VAS 5 how ever he gives 10mg of Diazepam. that high a dose can not be given in the uk and is essential to his successes rate plus he does not treat post menopausal women                                                                                                                                                                                                                                                                           there simply is only a hand full of gynecologists as skilled as he is in the uk plus the training in the uk is extremely poor and accesses to proper simulators (one that score on performance they say if you caused pain)  limited to a few hours if they see one at all instead they train on a piece of rubber  as its only £2000 for the machine and £45 for womb simulator with 7 polyps

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I underwent an extremely painful endometrial biopsy at an outpatient appointment when I was just expecting a transvaginal ultrasound scan. At no point was I given any information, pain relief or follow up advice. I had to attend OOH following my phone call to 111 for advice about intense pains akin to labour contractions and passing a large clot. I have now had 2 further emergency GP appointments, a vaginal swab and now need a ultrasound scan. At no point was I asked to consent to this procedure. I have made a written complaint which I will attach. I’ve cancelled a follow up appointment with the consultant due to his poor communication and my lack of trust. My letter of complaint has been acknowledged and I am being transferred to a different hospital and consultant 

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I experienced an extremely painful hysteroscopy (they also conducted a biopsy and fitted me with the Mirena coil at the same time) in September 2019.

I then complained to the hospital about the lack of information I received prior to my procedure. I was told that it would just be a bit uncomfortable, “I like a smear test”, and not offered pain relief when in fact it was the most painful experience of my life.

A link to my full complaint is below which should hopefully work and explain what happened to me.

Last week I finally had my complaints meeting which was held on 7th February 2020. Although the consultant did apologise for not explaining to me how painful it can be, I found parts of the meeting to be very dismissive. I was told that “most women tolerate it” and that because I’d given birth naturally, twice, they thought I’d be okay without pain relief.

This whole experience has completely shattered my trust in medical professionals and I have been left requiring CBT and diagnosed with PTSD as a direct result. I am so angry that I was not given the full facts prior to my procedure and denied my right of informed consent.

https://www.careopinion.org.uk/710768

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I attended my local hospital for my hysteroscopy feeling only mild anxiety. The leaflets I had been provided with stated that I should take painkillers such as paracetamol prior to the procedure. I must admit that I did forget to take any. The leaflets described that I may feel pain such as period type pain and a bit of discomfort.

I did think it odd that a nurse stood beside me and made lots of small talk but I though ok she is just being friendly. Now I know it is to try and distract me from what I can only describe as the most barbaric and inhumane procedure I have ever had to endure. Paracetamol would not have made any difference.

I was gasping and crying with the pain - it was so unexpected. I actually felt like I was having contraptions and that I was going to vomit and pass out.

To be fair the doctor did stop when I asked her to. I was then just told to get dressed and await a referral for the procedure under a GA.

I have never given birth and my view is that a hysteroscopy should never be performed as an out -patient for women who have never given birth.

I left the room weeping and almost hysterical.

Never again.

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On 09/02/2020 at 10:56, shirley herbert said:

I had one 3 years ago and found it very painful. No sedation was offered. I've got an appointment for another later this month and some info I got this time was to take Ibuprofen an hour before the appointment. The pain I felt last time won't be stopped by Ibuprofen,.. I phoned the Oncology nurse who said only if it proves too painful will they stop it and arrange for a general anesthetic for it... My point here is,, it in my opinion should be made an option right from the start. I obviously don't want any delay in a diagnosis and why once again I don't want it deferred till they can offer anaesthetic... but I'm absolutely dreading it.. Last time I thought I might burst a blood vessel the pain was so bad I think it a dreadful state of affairs for this proceedure not to have some sedation.

It is your right to request a general anesthetic.No woman should suffer this barbaric, invasive procedure.Too many of us have suffered.It is time for change.

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On 09/02/2020 at 10:56, shirley herbert said:

I had one 3 years ago and found it very painful. No sedation was offered. I've got an appointment for another later this month and some info I got this time was to take Ibuprofen an hour before the appointment. The pain I felt last time won't be stopped by Ibuprofen,.. I phoned the Oncology nurse who said only if it proves too painful will they stop it and arrange for a general anesthetic for it... My point here is,, it in my opinion should be made an option right from the start. I obviously don't want any delay in a diagnosis and why once again I don't want it deferred till they can offer anaesthetic... but I'm absolutely dreading it.. Last time I thought I might burst a blood vessel the pain was so bad I think it a dreadful state of affairs for this proceedure not to have some sedation.

I had a very painful hysteroscopy this year. My experience was exactly the same as yours and I have heard recently that another family member had a similar experience.  Please don't put yourself through this AGAIN. I was furious on behalf of younger women who would feel violated and not complain. Insist on a general anaesthetic and do NOT accept the assurances that two paracetamol will sort out the pain. You deserve better treatment than this. A general anaesthetic is available to all women if requested, or find another consultant. 

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On 08/02/2020 at 13:24, Claire Cox said:

Really sorry to hear this.   There must be places that do this procedure well.   It would be fantastic to hear about what ‘gold standard’ is and ensure all women have this same standard of care. 

Have you found any 'gold standard' Claire? These reports are very similar to my experience. I wrote a letter of complaint, and was persuaded to remove the complaint once I was assured that changes would be made - but I wonder if they have been implemented. A younger and less confident woman would go home and cry feeling violated. It's a disgrace. Pain levels 0-10 should be taken after the procedure to inform medical staff who seem ignorant or insensitive to the pain being inflicted. Inane chatter by two assisting nurses is no cover up, so I suggest it stops. 

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Hi Una,

This is all new to me.  This area of healthcare has been highlighted as an issue by you wonderful ladies.  Patient Safety Learning will be assisting you in this campaign.  

We will be setting out a strategy on how best we can help.  First steps will be to find out what is actually going on right now and what the 'best standard' is at the moment - we care capturing your experiences here, on the hub.  We will then look to see what standards are also going on right now.

It makes very difficult reading,  we want to help.

 

Thank you for posting

 

Claire

 

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Hi Claire

its not a new experience - I believe the topic has also been covered some time ago on Women's Hour, and there is already a campaign on line for pain free hysteroscopy. I've had four children by natural delivery, uterine contraceptive devices fitted, no problem with anxiety or having cervical smears - but this procedure is on a totally different level! Barbaric and unbelievable. If I hadn't complained I'd have been counted as a 'successful' procedure, as at the time I was too shocked to say anything. When I got home I realised she'd I owed it to others to make the complaint to my local hospital. 

Ill pay privately for general anaesthetic if I have to, if I ever need another hysteroscopy. 

Kindest Regards

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31 minutes ago, Una Lyons said:

Hi Claire

its not a new experience - I believe the topic has also been covered some time ago on Women's Hour, and there is already a campaign on line for pain free hysteroscopy. I've had four children by natural delivery, uterine contraceptive devices fitted, no problem with anxiety or having cervical smears - but this procedure is on a totally different level! Barbaric and unbelievable. If I hadn't complained I'd have been counted as a 'successful' procedure, as at the time I was too shocked to say anything. When I got home I realised she'd I owed it to others to make the complaint to my local hospital. 

Ill pay privately for general anaesthetic if I have to, if I ever need another hysteroscopy. 

Kindest Regards

It was covered on womens hour & there have been articles in the Daily Mail. Radio Shropshire also covered OPH. 

Please be aware that you do not have to pay for a GA if you need another Hysteroscopy, you are within your rights to request it. The RCOG patient information leaflet will give you more details.

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On 08/02/2020 at 23:03, Kathy Nabbie said:

It's great the hospitals are highlighted in the link- In one story the patient did not know the people in the room- This is poor  practice! Everyone in the room should be introduced to the patient- This is part of protocol and if not followed, is  also disrespectful.

I hadn't met the hysteroscopist or the 2 nurses before I entered the room for the procedure.  Also had no idea what was about to happen as hadn't received any information.

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Here's the link to the patient info leaflet that the excellent Dr Mary Connor FRCOG (Sheffield Hospital) wrote in conjunction with members of the Campaign Against Painful Hysteroscopy and the RCOG patient info committee: https://www.rcog.org.uk/en/patients/patient-leaflets/outpatient-hysteroscopy

The leaflet clearly states the risk of severe pain during outpatient hysteroscopy, and lists cohorts of patients at greatest risk.

It says that women may choose to have a GA upfront (so needn't be forced through 'Trial by OP Hysteroscopy').

Unfortunately, responses gained under the Freedom of Info Act and stories told to the campaign show that most NHS hospital Trusts

don't use the RCOG leaflet

don't warn patients of the risk of severe pain

don't offer patients GA or sedation 

don't stop OP hysteroscopy when the patient is in severe pain

Influential hysteroscopists from the British Society for Gynaecological Endoscopy have over the years influenced the outpatient Best Practice Tariff so that hospitals have practically no theatre space or anaesthetists to perform hysteroscopy with GA or sedation.  Training for hysteroscopists is often minimal and they learn on red peppers and conscious patients since high-fidelity simulators are too expensive.

We're the next scandal following vaginal mesh. 

 

CAPHJemmaThorneLOGOdefinitive.jpg

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I had an outpatient hysteroscopy for which my informed consent was not obtained. This was before Montogomery rules applied. I was completely misled re: the possibility of pain. If it was mentioned at all, it would have been described as being like period pain. As I had suffered from severe dysmenorrhoea from day one, I might have considered this to be acceptable.  I was not offered any pain relief, nor was I given the option of a GA. I was most definitely not a candidate for this procedure as an outpatient: I was post menopausal, have not given birth, and have a retroverted uterus, all of which are contraindications. I have never felt such pain in my life. It was absolutely excruciating, and as a result I dropped my blood pressure to my boots ( I assume, because no observations were recorded, which is in itself unacceptable ). In layman's terms, I passed out. Not only did the female Dr who performed this torture shove the hysteroscope through my cervix roughly, she took an endometrial biopsy, which was when I passed out. There was no help from what I presume was a nurse, who was also present, and I was unceremoniously dumped in a corridor, with oxygen in situ, for about half an hour, my reaction clearly being a source of irritation to both members of staff. I was led to believe that my response to their barbarity was as rare as hen's teeth, only to discover years later that it was not, indeed it is a common occurrence. This practice is being promoted inappropriately as the gold standard for the investigation of heavy menstrual bleeding, but this is a disgrace of national proportions.

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I had an horrendous experience at Salford Royal Hospital when undergoing an outpatient/ office based hysteroscopy. 

I suffered the highest level of pain I have ever experienced during any procedure.  

It was also performed with a total lack of care for my wellbeing and left me feeling traumatised and mistrusting of this clinic .

I do not know why I was not offered pain relief or the option of General Anesthetic or other sedation. I also cannot understand why the Gynaecologist did not speak throughout the procedure or offer any comfort even though I was crying out in pain shaking and sweating. The fact that the student nurse present informed me that the patient before screamed throughout tells me all I need to know about the level of patient care offered in this clinic. 

 

Salford Royal has treated many of my family members and their standards of healthcare are usually wonderful. Sadly Gynaecology and Outpatient hysteroscopy at this hospital is barbaric!!! 

 

Read my full experience  here 

 

https://www.careopinion.org.uk/319772

 

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Edited by Deb Drinkwater

Just dropping back in to add that I recently heard of a woman not even being given a consent form to sign for this procedure at an NHS hospital. This was for a recent procedure that was POST Montgomery. How can they get away with breaking the law like this?

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I don’t have experience of the Lidocaine, but the intense pressure of the water being forced into my womb through my vagina was part of the problem. They had to turn down the pressure as it was painful and uncomfortable. Is this a UK or US procedure as I am in the UK?

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Hi @Florrie it looks like this study took place in Egypt, I am not sure whether this treatment is available in the UK. Perhaps this was a small research sample only and it is not widely available. They conclude that: 'Flushing of the cervical canal and uterine cavity with local anaesthetic significantly decreased pain sensation in women undergoing office hysteroscopy.' 

Does anyone else know if this is offered in the UK?

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@PatientSafetyLearning Team this is defiantly not offered in the uk. the uk is very far behind in pan control and pain control studies. in fact the uk is obsessed with not using any pain relief  a recreant trail at Birmingham women's hospital called the vast trail compered vigscopic (no speculum) vers speculum and found the vagiscopic  method to be about 0.26 of a vas score better than speculum pain was measured o to 10 .10 being method pain                                                                                                                                                                                                                                                             the conclusion of the studie was was viagscopic should be used as default but there were pain scores of 8, 9, and even 10,s and there was a infection rate of %5 none of which was addressed i have attached the trail                                                                                                                                                                                                                                                 to top it of there is plenty of research money for Birmingham to do real pain control studies we have a working theory why they do not want to use anesthetic if you would like to her please say

Vaginoscopy Against Standard Treatment.pdf

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