Elliemay

So sorry to read this Cassandria.   I hope you are putting in a complaint when you feel strong enough and have all this behind you. Such a dreadful ordeal. The lack of care and empathy being shown to women in these procedures is astounding.  But what makes it worse is how they withhold information about likelihood of pain and deny access to appropriate anaesthetic and blatantly LIE TO US.  So professionally unethical!  If you haven't already have a look at the Campaign Against Painful Hysteroscopy Facebook and webpage (@HysteroscopyA on twitter ) and Care Opinion. CAPH have a pain survey already completed by over 5000 women who have had dreadful experiences. You are far from alone. Hope you feel better very soon. X

So sorry to hear this EmilyGee.  A dreadful experience.  The Campaign Against Painful Hysteroscopy is working really hard to get this appalling state of affairs changed and also supporting women who've been through and been harmed by this procedure.  If you would like to contact us, we have a public facebook page and also a private one.  The webpage is  https://www.hysteroscopyaction.org.uk/  https://www.facebook.com/HysteroscopyA

Awful isn't it? Sorry you've suffered too.  Evidently we're all so keen to get back to our childcare duties, we don't want anaesthetic.  There is a ridiculous survey by  the British Society for Gynaecological Endoscopy which claims that over 90% of women having this procedure would have it the same way if they needed it again, even the ones experiencing severe pain. There were no alternatives offered on the questionnaire.  Just laughable and this is now being used as the standard for benchmarking!  We just have to keep on making a noise to bring about change.  Have you seen the Campaign for Painful Hysteroscopy facebook page and website? (https://www.hysteroscopyaction.org.uk/)  They are also very active on Twitter @HysteroscopyA - do join in!  They have done some incredible work collecting data etc., and have already brought about changes in patient info leaflets.  A few years ago, pain wasn't acknowledged at all! 

Good to hear you didn't have any problems, Rainyflower - most women are ok with the procedure and it sounds as if you had a good dr for yours.  Unfortunately 1 in 3 women experience severe pain in outpatient hysteroscopy procedures, and have procedures that last a lot longer than 2 minutes.  Mine was at least 20 minutes, during which time I experienced excruciating pain, felt myself passing out as they tried to get through my cervix ( I was 20 yrs post menopause), the distension fluid for the biopsy procedure to take place felt like a red hot poker being applied to my uterus and up to my ovaries.  I wasn't advised to take any painkillers beforehand, and wasn't offered a local anaesthetic into the cervix until it was clear I was in agony.  No time was allowed for this to have any effect before they continued.  I've never experienced pain like it and I'm not alone with saying it was worse than childbirth.  Many women are left with PTSD after this barbaric treatment, often leaving women with wrecked sex lives and relationships.  This is the only endoscopy procedure where sedation with analgesia and/or general anaesthetic isn't offered as a matter of course.  Strangely, its also the only one that is a woman only procedure.  It would never happen to a man!

19 minutes ago, Carrie said:

Hello Katherine,

It's not the Campaign Against Painful Hysteroscopy that's preventing me from having the procedure, it's having a personal barbaric experience of it myself.

It may be the best procedure for ruling out womb cancer, but if women can't tolerate it due to lack of pain management then the procedure is useless.

I do wonder how many women have said 'no' to having a second or more hysteroscopies because of previous experience??

Gynaecologists need to remember that they do not have a second chance to make a good first impression!

Brilliant work being done by the campaign - great to be reassured that I'm not the only woman who has experienced this. Thank you for all your hard work - so appreciated!

Carrie, my outpatient procedure failed because of the severe pain - I had a polyp they couldn't remove although they did manage to obtain enough tissue for a biopsy.  I had another procedure a short time afterwards under a general anaesthetic - the experience couldn't have been more different.  No pain, knew nothing about it, and minimal pain for a short time afterwards. The gynaecologist I saw was amazed the outpatient procedure had occurred - lovely team of people who looked after me, chat with anaesthetist beforehand.  Just writing this, in case it is helpful for you or other women in the same position.

16 hours ago, Katharine Tylko said:

I'd very respectfully say there's masses and masses of research into outpatient hysteroscopy pain.  The Campaign Against Painful Hysteroscopy has been in existence for over 7 years.  We've read several hundred papers and audits on outpatient hysteroscopy pain.  The most recent survey of 5,000+ patients done by the British Society for Gynaecological Endoscopy showed a mean pain score of 5.2/10.  Individual hospitals are currently reporting 1 in 3 outpatient hysteroscopies as causing SEVERE pain of 7/10 or more.   The Royal College of Obstetricians & Gynaecologists have produced a leaflet (with input from our campaign) that lists some of the well-known risk factors for severe pain, e.g. previous traumatic gynae procedures; severe period pain; anxiety/depression.  Very sadly, because of a shortage of 1,400 anaesthetists in the NHS, most women are being put through Trial by Outpatient Hysteroscopy and only when the pain is unbearable are they offered general/regional anaesthetic or IV sedation with analgesia.  It's a scandal.

There are detailed Cochrane reviews which clearly explain the innervation of the vagina, cervical canal and uterus.  There are different types of nerves all over the place, including at the top of the womb where the biopsies are taken.  Hysteroscopy is inherently painful.  For it to be minimally painful there must be 1) careful selection of patients, 2) modern thin scopes and fluid management systems, 3) a highly trained, experienced and compassionate team.  Very sadly it's uncommon that all 3 factors are in place.  Women who haven't had a vaginal delivery or who are past the menopause have a much narrower cervical canal than a woman who has recently had a baby.  Hysteroscopists know that dilating the canal will be extremely painful - just like childbirth!  Unfortunately, fewer and fewer gynaecologists are prepared (or allowed) to take the time needed to do pain-free injections around the cervix.  Many prefer not to give an injection because this can produce a vaso-vagal reaction - but also because it takes up precious time.  So a political decision has been taken by members of the British Society for Gynaecological Endoscopy to promote routine conveyor belt  outpatient hysteroscopy without pre-op assessment and therefore with only over-the-counter medication from home (which will not touch the severe pain experienced by 1 in 3). 

We're campaigning for INFORMED CHOICE.  At the moment 2 in 3 women will not have severe pain during an outpatient hysteroscopy.  The problem is that NHS Trusts are not being truthful with patients and are not warning them of the risk of severe pain and of the well-known risk factors.  They are only mentioning 'mild discomfort'.  

We want every woman to be able to choose the pain-control strategy that's best for her as an individual - from 'vocal local' hairdresser chit-chat; entonox; penthrox (green whistle); local anaesthetic; spinal anaesthetic; general anaesthetic; IV 'conscious' sedation with anaesthesia.   Some people are quite happy to be awake and can tolerate brief acute pain.  Other people find the stirrups, the scope, dilators and blood on the floor totally gruesome.   

Let's hope the long-awaited Women's Health Strategy finally respects a woman's right not to be sexually brutalised during a medical procedure.

 

Very well summarised, Katharine.  As far as I can see from reading peoples ongoing horror stories about outpatient hysteroscopy, nothing has changed in the way women are tortured and gaslighted since I had my excruciatingly painful procedure about 9 years ago.  What has changed is the RCOG and BSGE have acknowledged that the procedure is severely painful for 1 in 3 women and that women should be told this and offered GA if that's their preference.  What hasn't changed is the culture of lying to women about the pain, ignoring the updated guidelines and therefore denying women their rights and their ability to give informed consent, not using RCOG patient information (presumably because they want to push women through on the OPH conveyor belt), and the unfeeling attitude of the medical staff who continue with procedures even when women are fainting, screaming, shouting, asking them to stop.  "Nearly over" or "just a few seconds more" is not acceptable when a woman has endured more than enough pain already!  They should hang their heads in shame!  Surely the Women's Health Strategy can't ignore this horrendous state of affairs!

54 minutes ago, A_P said:

So sorry to read this and to know that there was another person that had to go through this inhumane treatment. I felt every step of your journey including the bumpy roads... Having read law as part of my degree, I can see our cases being discussed at the European Court of Human Rights... 

Hasn't this government just removed our human rights and access to the European Court of Human Rights?

9 hours ago, Virgo86 said:

 

I started writing this from my bed at 23:00 having just had my first Hysteroscopy at 15:00 that day. Over 48hrs after now & need to tell my story. I do not want to scare anyone but my story is not unique and I don’t wish this experience on anyone. It should not be allowed to happen in 2022.

I am 35 (no kids) & spent the last 1 year+ having appointments and investigations for bleeding between excruciating, heavy periods. The past year was full of issues with missing referrals, and then my pathway documents being ‘lost’ by the hospital. I spent much time on the phone chasing up on my ‘care’ the past year and already had little trust in the clinic (Salford Royal Gynae with it’s peeling walls, mismatched chairs, underfunded aesthetic). I was glad to be going in to remove what was likely a 2cm benign polyp & was hopeful this hysteroscopy would be the final ‘simple’ procedure.

When I finally received my pamphlet (the day before!) it was like the advice I had read online from healthcare professionals. ‘Take the pain relief before’, ‘Might experience cramp like pains’, ‘can go straight back to work’ ‘recovery 1-2 days if biopsy is taken ’. Lies! It was grossly downplayed! I turned up alone (mistake), gave a urine sample and sat in a waiting room to listen to smooth FM. I was feeling a bit nervous never having had a hysteroscopy before but the nurse who came to walk me into the room seemed happy and breezy. I thought... can’t be too bad. I entered the room which looked like a large doctors office but with a stirrup chair, curtains and lots of equipment around it. I was telling myself, surely something done in this environment cannot be that bad. The Dr was lovely and chatty, read through a form and I signed. Said I could have a local anesthetic to the cervix and even though I said oh I’m absolutely fine with injections/dentists, have a high pain threshold etc he firmly stated that it would likely be more painful having the injection than just going through it (alarm bells!). I was then asked by a 2nd nurse to change behind a curtain to put on a gown then straight into the chair to be positioned. My heart started racing at this point (natural I thought) and then all of a sudden he was talking, cleaning the outside, a speculum went in then cleaning the inside. All the time the 2 nurses were asking me questions and I was chatting nervously away making jokes and then it happened. The next part is burned into my brain moment by moment. 

 

I wanted to scream & cry looking up at the ‘wheres Wally’ on the ceiling (I never ever want to see that book anywhere again). I tried to keep talking sentences but I couldn’t, I couldn’t breathe, I felt out of body at times. I remember looking at the screen and forcing myself to try and listen to what he was saying while I felt every movement a pain I can’t even describe (I’ve had to have morphine in the past for painful injuries and this pain was even higher than those incidences). The Dr said the polyp was a mix with a fibroid and I could see it was large (in the space between my left and right tube) he asked if he could try take more away & I couldn’t believe he suggested it! I said no please stop. When he said it was over I was shaking, cold, shivery & hot at the same time. I joked about not being able to stand up when I was left to get myself off the bed & felt I might vomit. Once changed he said me down & I signed a form for a general anesthetic (shaking throughout). 

 

I was in a state of shock for the next few hours. I sat in the sad ‘post procedure waiting room’ where you are left & forgotten about with your hot drink & biscuit, phoned my family, chatting away about it all in a false ‘it was horrible but hey ho’ voice. Then tried to walk to the pharmacy & was shocked to find I could only shuffle, (you should be told you must bring someone with you, I’m a fitness fanatic and this shocked me to feel so weak) to pick up 2 medications for my periods until the GA (the first time since I raised my symptoms over a year ago that I have been offered any medication). Every step was agony in my womb, taking my breath away, I had to keep stopping. The Uber home every bump was agony & I’m still in pain today & bleeding (lies that it’s a ‘little spotting) and can’t walk properly. 

 

Not even 1 single woman should have to go through this procedure awake!! Even if 2/3rds find it bearable. Its simply barbaric. The worst part. I feel like I felt when I was raped by a ‘nice’ man when I was younger. Especially when I had the realization that the likely reason for the Dr and his assistants being so nice and chatty was because they were fully aware of the indescribable pain this procedure can cause a large percentage of women. I spent that evening awake at midnight crying hysterically having flashbacks of what happened. This is not like me. Why was everyone so nonchalant during the procedure? I know they are trying to keep you calm but it’s impossible they are not aware that this was trauma pain, I must have been white as a sheet and shaking, why was my blood pressure/heart rate not monitored, where was the gas&air that you get in A&E. Why is it so downplayed and why are women expected to bear this! I cant believe I’m reading stories of women saying it’s worse that childbirth and can’t help thinking if a man had to go through this would it have been banned without GA or adequate pain relief! How do we stop this?  

Sending love to all who have suffered this x 

 

 

I am so sorry and angry to read about your experience.  It is unbelievable that they are carrying out what is actually surgery in outpatients without anaesthetic in 2022, when pain relief is available. I hope you feel better very soon, although I doubt you will be able to forget this barbarity any time soon! There are RCOG and BSGE guidelines for this procedure and this hospital didn't follow them, but that is sadly the case for so many women all over UK.  Although you were asked to sign a consent form, this can't possibly be informed consent if you weren't made aware that the procedure can be painful for at least 33% of women and advised that you had other options, ie. having the procedure under GA. https://www.rcog.org.uk/for-the-public/browse-all-patient-information-leaflets/outpatient-hysteroscopy/   I'm a member of the private part of support/campaigning group Campaign Against Painful Hysteroscopy.  If you think it would be helpful and would like to join us (you will find many who have had similar experiences to you)  please send a FB friend request to me Elaine Falkner (holding the black and white cat) and I can invite you to join our private group.  Its a very friendly and supportive group. We have members who can advise regarding complaining if that is something you would like to do, many have written to their MPs, and you can follow us on Twitter @HysteroscopyA .  You can also post your "story" on https://www.careopinion.org.uk/.   This is an account regarding hysteroscopy at Salford Royal from 5 years ago - clearly nothing has changed in that time: https://www.careopinion.org.uk/319772  .

Please look after yourself and give yourself time to recover. xx

14 minutes ago, Guest SadieCD said:

Also, I told my doctor to stop. She did until the pain subsided then she started again. It was not explained to me that I had other options. That is wrong. I don’t feel I have informed concept because I didn’t have all the information. 

So sorry to hear you had this experience Sadie.  Hope you are ok now.

On 25/04/2022 at 23:46, Martina said:

I am so glad I have found this page. I live in Cork, Ireland and today I have had an ultrasound to investigate post menopausal bleeding I had 3 weeks ago. It was decided today that the ultrasound did not provide sufficient information and that a hysteroscopy was required. They mentioned fibroids and a polyp. I overheard the conversation and questioned it, but was advised that the hysteroscopy would provide more Information. Further, I was advised that most women were able to tolerate the procedure well in an Outpatient setting, that only about 10% needed to have it done under GA. Initially I felt reassured, but I might now request to have it done under GA as I suffer from Vaginal Atrophy etc which is treated with Vagifem, a local Estrogen tablet. But I am so scared now of this procedure. The problem are the long waiting lists here. I am afraid of the long waiting period. The Outpatient hysteroscopy can be carried out in 2 weeks. They are due to contact me with an appointment tomorrow morning...I am undecided what to do, but I think it is best to wait to have it done in a hospital setting judging by accounts from women here. I sincerely hope that anybody who has suffered trauma through this will recover fully as this sounds a barbaric procedure both physically and mentally..

Hi Martina

Bit late in the day to respond but I've only just seen your post, I hope all is progressing well for you and you don't have to wait too long if you decide to have the procedure under GA.  

Very best wishes, E x

On 06/05/2022 at 20:01, Missy said:

I had a hysteroscopy on Wednesday afternoon, it was excruciating, had I known previous as to how painful it would be I'd never have ahead. Today 2 days later I'm getting horrendous pain in my hips and down my legs, it looks as though the procedure wasn't a success and I may need it done again, I've already spoken with my G.P and stated the only way that will happen is if I get a general anaesthetic. 

Missy, this is awful - so sorry to hear this.  Very pleased to hear you are talking to your GP.  Have you told them about the pain you are in?  There are a lot of women who have undergone this procedure and had it fail because of pain, and have then gone on to have the procedure under GA.  This should be an option for you as it is in the RCOG and BSGE guidelines. The Campaign Against Painful Hysteroscopy has a private group where we can discuss our experiences and support each other.  If you would like to join please send a facebook request to Elaine Falkner (I'm the one holding the black and white cat) and I can then invite you to join the group. 

Best wishes - I hope the next stage is better for you. xx

On 30/04/2022 at 14:04, A_P said:

As part of my recurrent miscarriage tests, I was invited for an operative hysteroscopy as I had a small polyp (2mm) at Ealing Hospital.

The letter I received from the NHS stated that I may feel some discomfort similar to a menstrual period cramp and that I should take two tablets of paracetamol and one tablet of ibuprofen. I wasn't offered any anaesthetic and the procedure was so painful that I felt like I was being raped.

Straight after the procedure, I was asked to leave the room even though I could barely stand.

It had no impact on my recurrent miscarriages but it affected my mental wellbeing, and I am mentally still recovering from it (a year after the procedure).

So sorry to hear this A_P.  It's appalling how women are treated with this procedure without adequate or any anaesthetic.  Unfortunately you are not the only one to be left with issues requiring counselling or other therapy for PTSD.  I hope you can recover from this ordeal very soon.   The Campaign Against Painful Hysteroscopy has an private group where we can discuss our experiences and support each other.  If you would like to join please send a facebook request to Elaine Falkner (I'm the one holding the black and white cat) and I can then invite you to join the group.  It would be helpful if you could message me your name as well if you would like to join us.

Best wishes

E

Hi Cake

So, so pleased to hear you've had a textbook experience of hysteroscopy. It's good to hear that your hospital is following the RCOG guidelines to the letter.  Its shocking how many aren't doing this and persuading women to go with outpatient procedures by telling them they'll have to wait a long time for other options, or worse not even telling them there are alternatives.  The Campaign Against Painful Hysteroscopy is working with RCOG endeavouring to bring about change so all women are treated as they should be, and not as NHS money and the outdated ideas of gynaecologists regarding pain in hysteroscopy are dictating. You can find CAPH on twitter @HysteroscopyA. Please support if you can. 

Hope the procedure has good outcomes for you. 

All the best,

Ellie 

Sorry Cathryn, I forgot to say I'm the one holding a black and white cat. 

Elaine 

Hello Cathryn, 

Sorry to hear you had a a bad experience last month. It not good enough is it? If you Google Hysteroscopy on Hansard all Lyn Brown's debate speeches will come up in date order.  Regarding making a complaint, if you would like to join the Campaign Against Painful Hysteroscopy's private group, we have several members who have made  complaints and could give some pointers on this. If you'd like to join please send me, Elaine Falkner a Facebook friend request, and I can invite you to join the closed hysteroscopy group.

Best wishes 

Elaine 

Hi Goldie Locks

Its so good to hear you had such wonderful, compassionate care and all went well for you.  Also good to know where the good gynae teams are! Gold Star to them!  I am a member of the Campaign Against Painful Hysteroscopy which wouldn't be needed if all hospitals were like yours.  We do stress that 2 out of 3 women will have no pain or mild to moderate pain.  Our intention isn't to frighten people  but to remind hospitals to follow the RCOG guidance of offering and providing general anaesthetic from the outset if that's what the woman wants, and stopping the moment the patient is in pain.  As you can tell from the previous posts here, that doesn't always happen.

Thanks for posting a good experience!

Best wishes

E

Shell,   What has happened to you is dreadful.  I can only imagine how you feel.  I've sent you a message.

Woody, I'm appalled to hear what has happened to you.  It shouldn't be like this.  As Exonian has said you are entitled to ask for the procedure under general anaesthetic and I wonder why this hasn't been offered to you and why they think a fourth attempt will be better at a different hospital.  I wonder if these are questions you could ask the new consultant.  If you would like to join the private facebook group that Exonian has mentioned, please send me a fb friend request (Elaine Falkner - I'm holding a black and white cat) and I can then invite you to join the group where you can get support and input from other women who know about the procedure.

Woody, I'm appalled to hear what has happened to you.  It shouldn't be like this.  As Exonian has said you are entitled to ask for the procedure under general anaesthetic and I wonder why this hasn't been offered to you and why they think a fourth attempt will be better at a different hospital.  I wonder if these are questions you could ask the new consultant.  If you would like to join the private facebook group that Exonian has mentioned, please send me a fb friend request (Elaine Falkner - I'm holding a black and white cat) and I can then invite you to join the group where you can get support and input from other women who know about the procedure.

On 24/12/2021 at 15:36, Jane Mactaggart said:

I have had 3 hysteroscopies at the JR in Oxford, each worse than the last. Almost the worst bit was being treated like a silly child making a fuss about nothing when I was In agony. I was led to believe than no one else had ever complained about the pain. I was not offered local or general anaesthetic beforehand, though on the last occasion they did finally give some LA in my cervix when they couldn’t get in otherwise. I was menopausal and childless, with several large fibroids, so they must have known it would be difficult and painful. I didn’t complain at the time because they diagnosed endometrial cancer at the third one, and I had other worries, but also because I didn’t think anyone would listen to me. I’m so glad to have it confirmed that I'm not hysterical or mad. Is there any progress on this issue? Or are NHS still pushing to have it done in Outpatients? Purely to save money of course….

Appalling!! 

It just goes on and on doesn't it - women being tortured in hysteroscopy procedures carried out in outpatients without anaesthetic.  Women are not able to give informed consent to the procedure because information is being withheld from them.  The RCOG Patient Information Leaflet state: "You may choose to have the hysteroscopy under general anaesthetic. This will be done in an operating theatre, usually as a daycase procedure."  (https://www.rcog.org.uk/en/patients/patient-leaflets/outpatient-hysteroscopy/ ) but hospital trusts choose not to use this information because it mentions pain and anaesthetic.  Women are being lied to when they are told it isn't painful - it is known that 1 in 3 women will experience severe pain and to say that it doesn't matter because it doesn't last long is just negligent!  What ever happened to "first do no harm!" How do they get away with it?  I am so sorry to read the recent accounts on here.  They are truly awful.  The Campaign Against Painful Hysteroscopy has been working to bring about change for 7 years now.  You can join us on twitter @HysteroscopyA, visit their facebook page at https://www.facebook.com/HysteroscopyA/  or their website at https://www.hysteroscopyaction.org.uk/, or if you feel you need support following your experience and would like to join a private group, please send me a message via facebook - https://www.facebook.com/elaine.falkner.7 .  You can also record your experience and name the hospital on https://www.careopinion.org.uk/ anonymously if you prefer, or make a formal complaint to the hospital concerned.

On 13/12/2021 at 09:35, Patient Safety Learning said:

I was subjected to an excruciating hysteroscopy in outpatients without being made aware of all the pain options. I was denied local analgesia when I asked about it beforehand and told it wouldn't be necessary as the pain would be slight cramping. It wasn't.

I noticed some light spotting about 6 weeks ago. I reported this to my GP, who sent me for an internal ultrasound. This identified slight thickening of the lining of my uterus (7mm), so I was sent for a hysteroscopy at Nevill Hall hospital, in Abergavenny. I received a leaflet in advance, which said 'some patients experience discomfort. If you find the procedure uncomfortable, please discuss this with the clinician'. it also stated that one of the frequent risks was pain. However, on the same page it said 'You will be offered local analgesia', so I didn't worry too much.

When I met the clinician in advance of the procedure, he explained any discomfort would be like period cramps. I asked about pain relief, but he repeated it would just be like period pains, if I experienced any pain at all. As I used to have dreadful period pains, have had coils inserted and removed, and have given birth naturally twice - once without pain relief - I thought I'd be fine with this. I'm usually pretty tough when it comes to pain, in any case. 

When the procedure started, I felt some discomfort when the hysteroscope went through my cervix, and remember saying 'Ow'. Then the most incredible, searing, tearing pain I have ever experienced - I guess it must have been the pressure of the saline. I found the arms of the bed to grab onto, and could hear myself shouting -No no no no no, stop stop stop-. The plan had been to take some pictures, followed by taking a sample of the lining of my uterus lining, but the clinician stopped the procedure having had a look and taken some pictures. They may have spoken to me and asked questions during this time, but I have no recollection of anything except the pain. When I finally opened my eyes, the clinician was nowhere to be seen, and the two nurses were asking if I was OK. I was extremely shaken and very out of it, from the pain and the shock.

After I'd recovered for a few minutes, still with my legs in the supports, and lying back in the examination chair, the nurses told me I should go and get dressed, which I did, very shakily. They then showed me out of the room to the clinician's room opposite. Another doctor was standing in the doorway of his office, and I wasn't asked in, or asked to take a seat. I just stood in the doorway, still dazed and very shaken. The clinician looked up at me from his desk and said everything looked fine and joked that he would give me a 10 year warranty, as all seemed in order. The nurse then pointed me towards the exit door and I was on my way out of the department, to drive myself home. There was no offer of anywhere to sit and recover. I felt a complete wimp, and as if I'd made a terrible fuss about nothing. And very confused. As I mentioned earlier, I'm usually really brave but this was the worst pain I'd ever experienced.

I had phoned the hospital the day before the procedure, as I'd noticed in the patient leaflet that it said I needed someone with me to take me home. The person I spoke to said that was because I would be given local anaesthetic, and if I had an accident on the way home, my car insurance would be invalidated. She said it was at my own risk if I attended on my own and drove myself home. Having driven many times after local anaesthetic, coming home from the dentist, I took the decision to attend the hospital on my own, as it was short notice to find someone to drive the 40 mile round trip, and I wanted this done as soon as possible in case there was a risk of cancer. As a result of this conversation I had fully expected to be given a local anaesthetic for the procedure. 

I got home and looked up 'Painful Hysteroscopy' online and was appalled (and partly reassured) to see that up to 25% of women experience severe pain. I had no idea there was an option to have this procedure done under general anaesthetic, although I probably wouldn't have gone for it anyway, as I was only expecting period pain type cramps. I have regular lower gastrointestinal endoscopies and sigmoidoscopies without anaesthesia and bear the discomfort pretty well. So I assumed this would be similar. 

I have gone from being pretty fearless and confident to being terrified of going back. I wrote this on the day it happened while it was still fresh in my mind.

63 year old woman. Procedure 16 Sept 2021 at Nevill Hall Hospital, Abergavenny

Appalling!! 

It just goes on and on doesn't it - women being tortured in hysteroscopy procedures carried out in outpatients without anaesthetic.  Women are not able to give informed consent to the procedure because information is being withheld from them.  The RCOG Patient Information Leaflet state: "You may choose to have the hysteroscopy under general anaesthetic. This will be done in an operating theatre, usually as a daycase procedure."  (https://www.rcog.org.uk/en/patients/patient-leaflets/outpatient-hysteroscopy/ ) but hospital trusts choose not to use this information because it mentions pain and anaesthetic.  Women are being lied to when they are told it isn't painful - it is known that 1 in 3 women will experience severe pain and to say that it doesn't matter because it doesn't last long is just negligent!  What ever happened to "first do no harm!" How do they get away with it?  I am so sorry to read the recent accounts on here.  They are truly awful.  The Campaign Against Painful Hysteroscopy has been working to bring about change for 7 years now.  You can join us on twitter @HysteroscopyA, visit their facebook page at https://www.facebook.com/HysteroscopyA/  or their website at https://www.hysteroscopyaction.org.uk/, or if you feel you need support following your experience and would like to join a private group, please send me a message via facebook - https://www.facebook.com/elaine.falkner.7 .  You can also record your experience and name the hospital on https://www.careopinion.org.uk/ anonymously if you prefer, or make a formal complaint to the hospital concerned.

Appalling!! 

It just goes on and on doesn't it - women being tortured in hysteroscopy procedures carried out in outpatients without anaesthetic.  Women are not able to give informed consent to the procedure because information is being withheld from them.  The RCOG Patient Information Leaflet state: "You may choose to have the hysteroscopy under general anaesthetic. This will be done in an operating theatre, usually as a daycase procedure."  (https://www.rcog.org.uk/en/patients/patient-leaflets/outpatient-hysteroscopy/ ) but hospital trusts choose not to use this information because it mentions pain and anaesthetic.  Women are being lied to when they are told it isn't painful - it is known that 1 in 3 women will experience severe pain and to say that it doesn't matter because it doesn't last long is just negligent!  What ever happened to "first do no harm!" How do they get away with it?  I am so sorry to read the recent accounts on here.  They are truly awful.  The Campaign Against Painful Hysteroscopy has been working to bring about change for 7 years now.  You can join us on twitter @HysteroscopyA, visit their facebook page at https://www.facebook.com/HysteroscopyA/  or their website at https://www.hysteroscopyaction.org.uk/, or if you feel you need support following your experience and would like to join a private group, please send me a message via facebook - https://www.facebook.com/elaine.falkner.7 .  You can also record your experience and name the hospital on https://www.careopinion.org.uk/ anonymously if you prefer, or make a formal complaint to the hospital concerned.

8 hours ago, SarahFox said:

I was utterly terrified going into this procedure due to reviews online, and whilst it was awful, I was lucky that it wasn't as bad for me as for some (and I would like to say I'm a wuss as far as pain goes).  I had mine at the Royal Hallamshire in Sheffield (UK).

I took two paracetemol and a mefanamic acid (a godsend) an hour before, and rung in advance to check if I would be able to get the gas and air (I have respiratory issues) which they were able to confirm I could.  I would recommend ringing up with queries before so you maybe feel a bit relaxed.

I pretty much broke down the minute I got in there and was shaking with fear and the staff were so thoughtful.  They explained I didn't have to have it, could stop if it hurt too much etc so I decided to try.  I was given the gas and air from the beginning, which combined with the drugs I'd taken did help but it wasn't without pain.

I struggle with speculums and explained that.  I find it super painful and that was awful but required for part of the procedure, and they tried to use the smallest one on my request and complete that part as soon as possible.

The gyno tried without anaesthetic but my cervix wasn't playing ball so I had 3 injections into it which thanks to the prior drugs and gas/air wasn't too bad, then he dilated it.  Once the speculum came out (once the camera was in) I felt a lot more comfy and just had some sharp period cramps at various points (again dampened by the pain relief) as well as the weird feeling when they fill you with water.

Afterwards I just felt very sore internally and had bleeding, but less than I do on my period as they are super heavy.

I have to go back for a spinal for them to take out some fibroids, as the gyno suggested that would be best for my comfort.

I would recommend the pre-drugs and explaining beforehand that you want all the pain relief.  I wouldn't want to do it again but based on this experience I wouldn't be as terrified the next time.  I wish anyone who is having one good luck 🙂

I'm very pleased it went well for you, Sarah.  I don't want to rain on your parade but think it might be useful for others to know how your experience might differ to experiences in other hospitals. Sheffield Hallamshire is known to be better than most at managing pain in hysteroscopy with spinal anaesthesia and others including gas and air being available - these aren't available in most hospitals for outpatient hysteroscopy. It is questioned by many gynos as to whether local anaesthetic to the cervix has any effect against pain, but maybe yours team allowed enough time for it to become effective before continuing, something else that often doesn't happen, and were adept in applying this local. They also explained to you that you could stop the procedure if too painful and what would happen if they did - something else that often doesn't happen. A final observation - if GA or spinal is available, why are women being subjected to painful procedures without. Does this happen to men? Best wishes for your future procedures. 

The Campaign Against Painful Hysteroscopy hears this all the time - "It was like being tortured by nice people".  Regardless of how supportive and kind they were, they should not have let the procedure continue if you were showing signs of severe pain and distress which you clearly were (see below).  They do it without anaesthetic to save money. The hospitals aren't paid any more for hysteroscopies for GA in Day wards or conscious sedation with analgesia in OP which requires an anaesthetist, but they are clearly more costly. There seems to be a myth that women can endure pain because of childbirth, periods etc., so ok to do in outpatients.  In some clinics gas and air is available and sometimes women are offered local anaesthetic into the cervix, but research shows that this is largely ineffective for pain control.  Also the manufacturers of the hysteroscopes use the discomfort/acceptability/cost-saving factors to sell their equipment, thus compounding the myth.  They also give free training to hysteroscopists and pay for gynaecology conferences.

Below are the key points from the RCOG patient information leaflet.  All of this should have been explained to you before the procedure and before you signed the consent form, otherwise it isn't informed consent.  Too many gynae depts don't even tell their patients it might be painful, preferring to say you might feel cramping like period pains.  Nothing could be further from the truth for so many women.  It just destroys trust and many women won't return for more procedures, not even regular smear tests.

Sorry, this has turned into a bit of a rant.  I had my procedure 8 years ago and become increasingly angry hearing that more and more women are suffering this barbaric procedure in this unnecessary way.  I've attached a couple of links below - one is to Care Opinion where you can post anonymously about the hospital and your experience - you'll find a lot of hysteroscopy accounts on there.  The other is to CAPH's survey - click on survey on Hysteroscopy Action webpage.  If you are on twitter you can follow the campaign @HysteroscopyA.

Best wishes for your recovery.

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

https://www.hysteroscopyaction.org.uk/

https://www.rcog.org.uk/en/patients/patient-leaflets/outpatient-hysteroscopy/

Key points

• Outpatient hysteroscopy (OPH) is a procedure carried out in the outpatient clinic that involves examination of the inside of your uterus (womb) with a thin telescope.
• There are many reasons why you may be referred for OPH, such as to investigate and/or treat abnormal bleeding, to remove a polyp seen on a scan or to remove a coil with missing threads.
• The actual procedure usually takes 10–15 minutes. It can take longer if you are having any additional procedures.
• You may feel pain or discomfort during OPH. It is recommended that you take pain relief 1–2 hours before the appointment.
• If it is too painful, it is important to let your healthcare professional know as the procedure can be stopped at any time.
• You may choose to have the hysteroscopy under general anaesthetic. This will be done in an operating theatre, usually as a daycase procedure.
• Possible risks with hysteroscopy include pain, feeling faint or sick, bleeding, infection and rarely uterine perforation (damage to the wall of the uterus). The risk of uterine perforation is lower during OPH than during hysteroscopy under general anaesthesia. 

Hi Dawn,  so sorry to hear this has happened to you.  What an awful experience. Unfortunately you are far from being alone with feeling extreme pain with hysteroscopy.  Research has shown that 1 in 4 women will experience severe pain. I hope this was explained to you before your procedure and you were given the opportunity to have it carried out under general anaesthetic or sedation. The RCOG guidelines state that all of this should be discussed with women prior to the procedure but unfortunately this very often doesn't happen.  Also the procedure should have been stopped given the pain and distress you experienced. The Campaign Against Painful Hysteroscopy is working tirelessly to bring about change but its an uphill battle.  Men would never be expected to go through a procedure this painful without anaesthetic.   Are you on facebook?  If so the campaign has a facebook page and from there you can ask to join a private group where women who have had a bad hysteroscopy experience can talk about it and support each other. Or message  https://www.hysteroscopyaction.org.uk/contact-us/.  I hope you begin to feel better very soon.