Preventable negative hysteroscopy experience

Summary

I recently experienced an extremely traumatic failed hysteroscopy. I stopped the procedure as the pain reached a level that made me feel unsafe. My cervix was torn during the procedure and I believe the pain associated with this could have been prevented. I have three potential factors that may have led to this: I am aged 67, have had one C Section and no vaginal birth. I also had laser treatment in my thirties so there was risk of scarring from that also.

Content

I am not presenting this information as a complaint, but to pose questions that might prevent others having the same negative experience.

At my appointment, all staff were lovely and put me at ease. I was not anxious prior to the procedure and my questions were answered clearly at the consent form stage.  I would consider myself to be fairly stoical about medical procedures, etc. Again, this is not a complaint and is presented as honest feedback. 

I had made the decision to have an outpatient hysteroscopy based on the assurance of the nurse at my first clinic appointment who assured me that it was a quick process that “although it’s a 30 minute appointment, the procedure takes two minutes”. 

I am 67. I explained at that appointment that I had previously had laser treatment for an abnormal smear test result. I explained that I had had one C section birth and no vaginal deliveries.  

I was concerned that these factors might make the procedure difficult. My fears were proven to be correct. The procedure was bearable to begin with. Then the person carrying out the procedure advised that my cervix was “tight” and that it would need to be dilated. I was given a pain relieving injection which was unpleasant but bearable. I was offered “gas and air” but up to and including the injection, I didn’t feel the need for this. The next part of the procedure was unacceptable. I experienced a searing pain (worse than labour pain; worse than the immediate after pain from a C section).

At this point I stopped the procedure. The camera had not been inserted into my cervix but my cervix had been torn. I was surprised at the amount of blood on the bed and the floor (whilst accepting that this would look worse because of the water used during the procedure). I asked why there was so much blood and was advised that my cervix had been torn “slightly” but that it would heal. 

I feel that if I had received an examination at my first clinic appointment, it might have been apparent that a hysteroscopy would have been too difficult to attempt without a general anaesthetic. Instead, I was reassured the procedure would last 2 minutes and was extremely straightforward. I now feel as though I have not received the proper investigation and am somewhat scarred by the experience. I was offered a repeat hysteroscopy under general anaesthetic but refused this. I could not contemplate this procedure being repeated. On reflection I should perhaps have been advised that a general anaesthetic would be preferable given my age and history. 

I have agreed to have a repeat scan in a few weeks to see if there have been any changes. If changes have occurred, I will then agree to a repeat hysteroscopy under general anaesthetic but will not undertake such a brutal procedure lightly even under anaesthetic.

I appreciate that hysteroscopy is a valuable and necessary means to detect cancer and am not being critical of staff. I just feel that I should have been examined before the procedure was commenced to determine if there were reasons why it might be especially painful. The experience has left me somewhat shocked and feeling that this is too invasive a process for an outpatient clinic. I went alone for my appointment and managed to drive back to work straight afterwards but was very shaken for the rest of the day. I was later able to speak to my gynaecologist  about my experience and he was at least able to explain the clinical technique in my detail.

Further reading on the hub:

• Hysteroscopy: 6 calls for action to prevent avoidable harm
• Read our community thread on women's experiences of Painful hysteroscopy
• My experience of an outpatient hysteroscopy procedure
• Hysteroscopy pain: A discussion with anaesthetists. A blog by Helen Hughes