Gynaecologists at Liverpool Women's Hospital

[MinaTina]

Has anyone had a hysteroscopy or laparoscopy at Liverpool Women's? Did you have GA or Local or none? The maternity seems to be more organised than the Gynaecology. Any opinions?

My friend recently had hysterectomy there and had GA for it. Why do you ask? are you going for one?

my own views of that hospital are that no department there is organised but thats another story

Thanks Honeypie19. I ask because I need a diagnosis, so trying to figure out if hysteroscopy with no anaesthetic would be suitable or laparoscopy with GA. There are lots of terrible reviews about hysteroscopy pain. Also not sure if I should opt for private, because all these gynaecologists seem to work in private as well. So I am hoping to get some reviews. The weird thing is none of these gynaecologists have any reviews online! So it makes me a little worried.

My colleague had one yesterday (not in Liverpool) and had a local anaesthetic, although she had the choice of either. She said she wished she'd had a general and would recommend anyone else to have a general as it was excruciating.

Sorry, probably not what you wanted to hear but at least you might have a better idea of how to decide.

I had one last month - not in Liverpool with no anaesthesia and it was no worse than a smear but they recommended ablation again with no anaesthesia and I’m slightly baulking at the idea

Ah bless her! StCharlotte to be honest no one seems to find it painless. So it does really stress me out. On the other hand I have heard a lot about women developing hernia at the site of laparoscope incisions. so that is also a worry. It's a terrible thing to need such an invasive diagnosis and many of us need it at some point in life. I hope your friend recovers soon. Big hugs. And thanks for the honest reply.

Now that's one I would not opt for matteroflifeordeath !! ablation with no anaesthetic! I wonder what these consultants think suggesting such a thing. Honestly, sometimes they can be ruthless. Medicine is still so much a matter of practicing on each case because each case is individual and different so they keep learning on patients' bodies. I personally would not have an ablation ever with no GA. I have friends who have done it under GA and they still suffered much pain and discomfort after.

I know it's not what you are asking, but my issue with Liverpool women's is that their gynae surgeons are very good, they have no other specialists in site, no blood labs, no blood bank, no ICU, and their HDU is in name only. So any complications during or after surgery mean you have to be blue lighted to one of the other hospitals, which takes time, and is not ideal. There is no option of getting, for instance, a bowel surgeon to pop in and give an opinion if they see something that is out of their remit while they are in there. If you bleed, they will have to get blood for transfusion from the royal or aintree.
Going private is fine as long as there no complications. If there are- see above.

Sorry for the scary stories- complications are rare. I am an ex ICU nurse and we only tend to see the worst case scenarios. Still, I feel that people should be aware of these issues

Good to know thank you- Im going to speak to my gp I think as the consultant (male) said most women don’t have a ga

Thank you so much differentkindofpenguin It is really good that you are pointing out these issues. I would rather hear all that can go wrong and be prepared than just go in and face a tragic situation without any prep! Thank you x

Good for you to discuss with your GP matteroflifeanddeath as patients, we have to advocate for ourselves or no body would really care. Take care x

I had a hysteroscopy at the Women’s under GA, but only because I’d had an attempted one done under GA before at a previous hospital, so knew a) it would be difficult, and b) I wasn’t prepared to have it done unless it was under GA.

The situation here is crazy with the separate hospital, and no onsite backup from any other specialities.

I never saw the consultant I was under, just nurses and a Reg. The hysteroscopy was done by the gynae oncology team as they are apparently the most experienced with difficult cases, but even they couldn’t get a proper view, due to my overly distorted anatomy thanks to lots of bowel surgery. But then no one I saw in clinic could answer any questions about why some things were written in the op notes as they weren’t the team that had done the investigation!

Hi Southwest12 I hope you are well now. I feel your pain. It seems like you have been through so much. Did they ever tell you why you were having the hysteroscopy under the reg and nurses instead of the consultant you first saw? It sounds all a bit irresponsible of them that they could not answer your questions about op notes. The CQC report on the gynaecology at Liverpool women's shows that they are not good enough anyways. But did you raise this issue with them to get some answers for the way they dealt with it so disjointedly!? x

I know nothing about Liverpool but in answer to some of your points...

Hysteroscopy and laparoscopy are not looking at the same things so in terms of which is ‘suitable’ for you it would depend on what your surgeon thinks is wrong.

It’s not uncommon for there to be no HDU/ICU ward in smaller hospitals doing minor surgery. Everything that’s needed to manage an emergency will be present in the theatre complex - we can do pretty much everything in an operating theatre that would be done in the first few hours in icu (in fact it’s not uncommon to bring patients to theatre specifically to start intensive care treatments if there isn’t a bed immediately available in ICU).

They would not be offering you surgery in a hospital without icu if they expected you to need it, or offering you surgery in which major blood loss is anticipated if they weren’t able to provide for it. There will be local plans & guidelines for what would happen in the event of serious problems (which would commonly cover ambulance transfer to a bigger hospital with an anaesthetist escort).

From an anaesthetist (who has been involved in training private hospitals in recognising periop complications & managing safe inter-hospital transfer).

Also, any registrar doing a solo list will have had appropriate training before being let loose in their own and will have a consultant on-site to whom they can refer if there are problems or surprises. (This applies to both surgeons & anaesthetists).

Greybeardy I did ask specifically about Liverpool in the first place and the focus is on patients' experiences, so your extended thoughts (from an anaesthetist perspective) is not helpful at all. I also want to know about other patients' recent lived experiences, because there seems to be some serious issues with some of the consultants' practice in other threads, so really there is no need to try and explain that registrars are all trained, indicating no errors take place. There is a campaign about hysteroscopy procedures across the country, causing PTSD and shock to many patients. So please, for goodness sake, have some respect for people's experiences instead of trying to project your scientific experience here. So much can go wrong with such procedures, perforated uterine lining being only one, let alone accidental puncturing of major vessels, etc. It would be interesting to see how consultants would feel if they were to undergo similar procedures and offer no answers to some patients. So, while the situation with gynaecology ward requires improvement from a CQC perspective, it is important that we find true lived experiences for ourselves rather than just relying on medics in general.

For anyone joining this thread, the hysteroscopy campaign website I have seen, has some good information on what can go wrong and what patients should know: www.hysteroscopyaction.org.uk/

Also, if anyone has seen any website where we can read reviews about gynaecologists at Liverpool Women's Hospital, please can you name the website so that my partner and I can have a look. It is very strange that we cannot find any reviews on the majority of these consultants.

Greybeardy, your points are valid, but as a critical care nurse in Liverpool, we frequently have transfers from the women's, both post gynae surgery, and pre and post partum patients. Obviously they can be looked after in theatre while awaiting a transfer to another hospital, but what about the risks involved in the inter hospital transfer? Particularly in maternity cases, we do get transfers after a haemorrhage, the delay in transfusion is so, so dangerous in my opinion. And unnecessary.
An HDU that cannot start non invasive CPAP, or look after an NG Fed person, tonne signs lack of confidence and knowledge of the staff. It's a fab little hospital, in a lot of ways, but for the extreme minority of people who get very sick, it's just not the place to be

Be aware of the serious potential complications of hysteroscopy and make sure you are aware of what symptoms to look out for.

Though rare, bowel perforation is one such risk. Early symptoms include severe shoulder pain (caused by gas escaping from the damaged bowel and rising up through the abdominal cavity to the thorax) and abdominal bloating. Do not allow A&E to tell you it is a pulled muscle and send you home with painkillers as they did to me! Ended up being blue lighted back in and had emergency colostomy operation and peritonitis.

Very unlikely to happen to you, but be aware and insist they don't send you home if you have symptoms like these.

Thank you WifeOfTiresias xx
You gave me so much to think about. I hope you are well now and recovered from that ordeal. Sounds really painful, horrific, and truly unacceptable. I have had experience of staff completely dismissing my pain so I can understand how some types of pain may be brushed off by A&E staff. xx

but they recommended ablation again with no anaesthesia and I’m slightly baulking at the idea

I cannot imagine it EVER being suggested to a man that he have the lining of one of his internal organs burned out with no anaesthetic. That is fucking barbaric and I would tell them NO in no uncertain terms. Misogyny in medicine is alive and well, women are regularly expected to have procedures that have great potential for pain with no bloody anaesthetic all the time.

timshelthechoice you are totally spot on. No man would ever allow that happen to them. The problem lies with us women as well, because we are still accepting that consultants and doctors dictate what they believe to be alright for us. What makes me really angry is that many female doctors endorse such barbarism!

I did a Critical Care junior doctor job at RLUH several years ago, @differentkindofpenguin - I wonder if I knew you! I share your concerns about the fact that LWH doesn't have other specialties on site. I don't live in Liverpool any more but I might have delivered my baby elsewhere if I did.

YouWhoNeverArrived- quite possibly, I've only just left after nearly 10 years, it's a small world!