Hysteroscopy experiences please?

[Summerscomin]

I had an internal ultrasound scan a few months ago as I was having irregular bleeding. Apparently they found what looks like "a small lump" in my endometrial lining and recommended a hysteroscopy- the appointment has come through and it's outpatient, no general anaesthetic offered.

I'm not sure whether to ask for a general or just give it a go and hope it's not unbearable?

On one hand, I suppose I'd have to wait longer for a general, they could refuse to do it under general, I could feel lousy from it (had general a few times as a child and been ok but not as an adult).

On the other hand, I have a tilted cervix and they usually have to delve about a bit to find it. I'm usually ok with smears but colposcopy/biopsy is another level and I nearly vomited last time. I did pass out for a short time with the biopsy. It was very uncomfortable.

Aware this is getting long now but want to add that I also had abnormal smears/CIN2 at the same time as all this (could've caused the bleeding?) and part of me wants to opt out of hysteroscopy completely. But worried that's foolish.

Any thoughts welcome!

I had one in 2021 to remove fibroids and polyps, and insisted on a GA. I’ve still got severe SPD from having DS2 27yrs ago, and have had 8 major pelvic surgeries, so I couldn’t have stayed still for them. My pelvic surgeon said he’d write to the gynaecologist if necessary but it didn’t come to that.

Ask for a GA. No man would have to have a procedure like this, wide awake without pain relief.

I had one recently and it was very very shocking i nearly fainted. Nothing like a smear. I have to have another and I'm having under general. They didn't offer me anything at all not even local.

I had one about 18 months ago to try to retrieve an errant mirena coil. Ultimately it was a failure (because the mirena was embedded) but the procedure itself was fine. A little bit uncomfortable but not painful (I had local anaesthetic). It was interesting looking at the screen and we had a good chat. I even asked the very senior consultant how the fact that suggesting only women have uteruses was about the most offensive thing one could say is affecting his career (he pretended not to hear me).

I had to have a it redone under a GA which was fine (I love a GA), but ultimately this was more hassle and knocked me out for a few days.

Little update.
I spoke to gynae today and the bottom line basically was I needed to try and have it done without GA. She was quite reassuring and said it wouldn't be as bad as my cervical biopsies (as it's higher up?!) and that it should be easier because I've had a vaginal delivery but I'm not feeling too great about any of it. She said I could have a local anaesthetic and there would be gas and air available. If it doesn't go well/they can't do it/they need more than just a biopsy, then they'll have me back for a general.
Rereading some of these and feeling quite sick. Agree with those saying this is misogyny/a feminist issue, no way would blokes have to do this.

Oh my god, that’s not on. Surely you get a choice. Too right they’re going higher, they’re going into your uterus and having a poke about. I had one and there was no question about doing it without a GA , that’s how they did them at the hospital I went to. She’s offering local anaesthetic and gas and air, gas and air is what your offered giving birth. Says something about possible Hysteroscopy pain.

I could tell she was a bit put out when I said I wanted a GA. She said it's not something they usually offer and the procedure is usually done in outpatients. I tried to say I was nervous about it having had quite a traumatic experience with the two cervical biopsies I've had this year but she basically said give it a try and take it from there, it'll be over in 15 minutes, I'd be alright and if I wasn't then GA is plan B.

I can see a GA is a bigger, and more costly, way of doing what could be a straightforward procedure. But at the same time I'm worried it's going to be absolutely awful and it's hard to forget trauma isn't it. (Have previously had vaginismus issues and worked hard to overcome this to live a normal life).

It's entirely up to you but personally (I haven't had one) I would be standing firm on the GA. I've always said if I need anything beyond a coil fitting they can knock me out

Her attitude is appalling. You need to consent to the procedure and she can't force you to have it without GA if that's what you want. It's more convenient for the clinic and cheaper if you don't but that's not your concern.

Could you complain to PALS and refer to the RCOG guidance? You've basically just had your concerns dismissed.

I had sedation and was completely out of it during the procedure. I asked my GP and she said there’s no way she’d have it without sedation, so I asked them to schedule the appointment so that that was possible. They didn’t argue about it at all, just gave me a different appointment. I was even given a pre-med before going to theatre as they deemed that I seemed anxious.

Pain is what the patient says it is.
Sadly many healthcare professionals forget or ignore this.

Thank you for all the responses.
I do feel a bit dismissed but at the same time she said along the lines of "obviously no one's going to pin you down and force you to go through with it but it's not bad and we've got pain relief" and I didn't argue or insist. I feel a bit like I'm making a big fuss when I don't even know what it'll be like.
I could be like one of the posters on here that's said it wasn't lovely but not horrific. Or it could be awful 😞. There's just no way of knowing is there.
Also getting cross with myself as I'm usually much more assertive than this! I think I'm just a bit frightened. I'd quite like a chat with my GP but getting an appt is nigh on impossible.

Thats the problem isn’t it, none of us know until we are actually having the procedure if it will be horrendous or fine, I watched the procedure on YouTube the patient was completely knocked out, after watching it I would insist on sedation as a minimum.

Im literally leaving the hospital now after mine. It’s a pain to have to wait afterwards, but I made the right choice with the ga, I woke up having felt no pain and can go home and cuddle in bed now

I had a large polyp removed under local. It was absolutely fine. I've heard some women have had the same procedure and it has been unbearable. I'd go for local again however it is a really tricky one as you just don't know how it's going to feel until you're there. I am sadly sure that if it were men going through an equivalent procedure that it would be done under general as standard.

I had a large polyp removed 3 weeks ago and they didn’t even give me a local!

I wanted a local anaesthetic but have not had natural births so they recommended a general. I was sore for a few days but given painkillers.

Just wanted to update. It turned out that I needed some further treatment (LLETZ) as well as the hysteroscopy so I insisted on a general and for the surgeon to do both procedures at the same time. I've had it now and, given the discomfort I'm still in, I'm so glad I went for the general. It was absolutely fine and I couldn't have gone through with either, let alone both, without it. Thanks all for your input!

Glad they agreed to the GA. I had GA for my LLETZ. Hope you feel much perkier in a couple of days.

I had one under general anaesthetic and it was totally fine. Out for the count obviously and I am so glad I had a general.

Even 2 consultants recommended doing it under general. I said I found the coil fitting AWFUL and nearly fainted.... to which they said, well absolutely have a general!

However, my IVF Dr abroad (male) said that a hysteroscopy does not hurt and only local needed....ummmm

I had hysteroscopy a few weeks ago and it was horrendous, booked over phone within 7 days as marked urgent cancer scare! Lining 8mm thick, menopausal, irregular bleeding, told outpatient appointments were very limited so agreed to take it, advised take otc painkillers, didn't do any research as thought if you only need otc pain relief it cant be that bad! Big mistake, the whole experience was traumatic, arrived at clinic (isle of wight) was called in by unresponsive assistant, large room, weird looking chair, corner of room with curtains, consultant sitting at computer, nurse prepping by chair, young chap student type sitting opposite me just looking, no introductions made from consultants, ask me some questions, one being why am I taking HRT! Gave me a leaflet, was told by assistant to go behind curtains and remove lower garments and there is a disposable pad like towel to wrap round my nakedness come out when ready. Shown to the chair, nurse was trying to make polite conversation when it all started, I was so embarrassed and in such pain I couldn't speak, my breathing was erratic I said I'm going to faint consultant said its coz the way I'm breathing! Nurse said take deep breaths, no one gave me any pain relief or said they'd stop even though I was in such pain, the student was just standing there watching me being subjected to this procedure, I couldn't look at him, it was horrendous experience. I cried as soon as I was out, got home and experienced extreme pain in my rib cage I had trouble breathing. I bleed for a few weeks after, I am having flash backs and cannot stop thinking it, I have referred myself to talking therapist hoping they can help me get over the experience, I have made a complaint to PALS about this consultant and that women should have the option of pain relief in the room. My saving grace is no cancer and a HRT review only and happily wont be subjected to another one again. I have lost confidence in Male gynecologists altogether.

PoliteNavyViewer - Similar experience to mine, barbaric and humiliating. Mine was made worse by the fact the consultant had to go back in three or possibly four times because she could not get a large enough sample for biopsy. Going on two years ago now but even reading about other womens bad experiences makes me feel stressed.

I had mine today and it wasn't anywhere near as bad as I thought it would be. The nurse and doctor were all brilliant and really put me at ease. Apparently my cervix had healed shut due to atrophy so they had to force it open which wasn't particularly pleasant and the biopsy was a bit uncomfortable but I only took paracetamol and ibuprofen and that's all I needed. Now I wait for the results which is certainly more stressful than the actual procedure.

WoodBurningStove - You were extremely lucky to be one of the 70% apparently, that are able to tolerate this procedure, well done you. I am so glad you did not have to experience what 30% of women suffer with this procedure. Out of interest, was there additional pain relief available should you have needed it, and did they explain they would stop if you needed too? I hope everything comes back ok. My results came back clear within 4 days just needed my HRT adjusted.