I need a gynae biopsy - "Take some painkillers before you come"

[CantFindTheBeat]

Hi all,

Not sure if I'm wrong to be a bit annoyed about this. I'm way past menopause and recently had some bleeding. GP took it seriously, sent for a scan, internal scan done, sonographer was fab, all great in terms of speed and service.

I've just received a call from a different unit to book in for a biopsy. Great again in terms of speed and process. I'm not that worried as sonographer was very reassuring, but I'm really pleased they are being thorough.

The person on the phone who called me to book said 'please ensure you take some pain killers before you come'. I said why is that? She said because it can be a painful procedure - you will have a local anaesthetic but it will be painful - i know, the things us women have to put up with!"

She was really pleasant and sympathetic, and it is the system, not her, of course. but I'm really apprehensive about the appointment. I have a very low tolerance for pain anyway unfortunately, and think this could be hideous.

I am so pleased that I am being investigated, but am I right to think that men would not be expected to have internal cells taken for a biopsy without proper anaesthetic and it's another thing women are expected to put up with?

Or am I wrong, and this is par for the course for everyone?

(and what painkillers should I take before the appointment?)

I think it might differ from consultant to consultant as mine advices GA.

I agree with you.
A friend had a gynae procedure done twice, it was burning off some cells. She was told the same as you on the first occasion, local anaesthetic and take over the counter pain killers before and after. She said despite this it hurt like hell so the second time she said she wouldn’t have it done without a general anaesthetic which the department reluctantly agreed to. The nurse at her second appointment admitted nobody who had it done once ever agreed to have it done again without a g.a.

GA are expensive and come with risks. At the moment you don't know theirs a problem so I'd take some nurofen and see how it goes, then take paracetamol after or other way round. If procedure too painful ask them to stop and revalidate Good Luck.

I had burning of the cells done twice and removal of fibroids and found it uncomfortable but nothing more but when I went to have my 5th coil inserted I was in that much pain they couldn't do it. My body went into spasms, and I was on painkillers for 6 days. Everyone is different but take tablets and go and see and if they have to stop then at least you tried

I had a uterine polyp removed with no anaesthesia. I wept silent tears of pain throughout, and although the staff (all women, both medics and nurses) were wonderfully kind, and the gynaecologist offered to stop, and do it in theatre with anaesthesia, I carried on. Looking back I don't know why! Maybe I thought it was better to endure and get it over with? If I had to do it again, I would for sure ask for a GA.
The pain was so intrusive and intense. I'm fairly stoic with pain (long term spinal and joint disorder), so I was taken by surprise by quite how bad it was.
Maybe have a chat with the medics and see what options you have.

Sounds like a hysterescopy with biopsy has been requested. There is some research that shows 1in 3 find them extremely painful.

I had one and had to stop part way through as it was too painful to continue (despite taking pain relief ahead of time). I had it completed under a GA.

Unfortunately it's hard to predict who will be fine and who will be in a lot of pain. There are some indications though, things like if you've never given birth vaginally or if you find smears painful, or you've suffered any sexual violence or trauma. None of those apply to me and I still couldn't manage.

Do some research so you feel more informed. Don't be afraid to ask for a GA if that is your preference and if you want to try without know that you can say stop at any point.

Thank you all.

I've had two babies and lots of smears but I'm just dreading this.

I'm going to talk to them. The sonographer told me that my uterine lining was nice and thin (which is good, apparently), and she could see where she thinks I've ovulated as I'm on HRT and it's not unheard of so I wasn't expecting a follow up biopsy.

I'll ring then and discuss - thank you.

Completely agree OP. If this was a male procedure it would come complete with opiates and instructions for bed rest. I always feel like a piece of meat on those obgyn tables, the procedures feel medieval and there's never any dignity when your vulva is at eye level on show for everyone to see. Hate it.

This is a huge bugbear of mine OP. I insist on proper pain relief before any procedure - asking people to take things like paracetamol and ibuprofen (which barely touches anything bar a slight headache) is horrendous.

Insist on a GA if necessary - the way the NHS neglect women this way is appalling. You will get proper pain relief but sadly you have to make a fuss - I know from experience!

Just commenting as the gynae procedures and painkillers / local anaesthetic have been a source of irritation for me for many years. Always question why men didn't have the same experience, any biopsy was with GA and opiates.

However, most places are now doing prostate biopsies with local anaesthetic now.

There’s been a lot of threads about this. I had one traumatic one without anything other than painkillers and they didn’t help at all. When I had to have another my gynaecologist told me not to put myself through it again and I had a general anaesthetic which was much better. I think it’s a cost saving exercise. For my first they wanted me to go to the appointment and try and see how painful I found it 😡. I think I went through with it because I was there and they’d started.

I wouldn't want to have a GA though, risky and takes ages to recover.

I would not have this procedure again without a GA.

I remember chaperoning for several prostate biopsies in a private surgeons rooms. No GA, and it didn't look like a walk in the park tbh. So men do have similar. Managing their urethral obstructions with catheters, syringing the clots out post resection. All was pretty bad so men do get a bit.

I had a womb biopsy done a few weeks ago, it was absolutely fine, bit nippy for about 30 secs, no worse than a smear or coil being inserted. Little bit of bleeding after and had a dull ache for a few hours. No way would I have GA for something so routine as they carry risks. You’ll be fine honestly

I had an hysteroscopy and biopsy last week. Not offered any analgesia at all. It was awful and I am still bleeding on day 8.

I had to have an emergency biopsy as I attended A&E with uncontrollable uterine bleeding, so they brought in the registrar gynaecologist to do it. I had no paracetamol and it was done in a random back room and I wasn’t expecting it so was apprehensive.

It was actually fine and as a pp said, the coil being inserted was more memorable. I’ve got a low pain threshold!

It depends which bit of you is being biopsied.

If it's your cervix it shouldn't be any more uncomfortable than a smear test.

But it does sound like it's your uterus lining, which means they have to open your cervix and go in (hysteroscopy). Not going to lie, this is painful for a lot of women (but some are fine). I found it horrendous, and only just managed to hang on until the end of the procedure.

Impossible to know how you'll get on, but there are risks with GA, so worth trying without.

If everyone had a GA the waiting lists would be even longer, and for some women the risks of a GA are significant.

I appreciate it's not a pleasant procedure though, about a third of women find them too painful to complete.

You may find pain relief containing codeine better, if you're able to take it?

I think the advice to take pre-procedure Paracetamol/Nurofen is nonsense - I don't think you can prevent pain in such a way.

I'm a nurse so only really experienced with post-procedure analgesia - are there any anaesthetists out there who could tell us the truth?

I had GA for my hysteroscopies/biopsies - as advised by my female surgeon.

For those advocating GA, the fact that any woman needs to have a biopsy in the first suggest it’s urgent. Having to wait for a theatre to become available and an anaesthetist would result in a much longer waiting time. Not to mention a GA doesn’t come without risks.

I had to give birth with both my children without the option to have an epidural, because the hospital didn’t offer them. I found that to be barbaric because labour goes on for ages and is extremely painful. There was actually an anaesthetist available but only for emergencies.

I had a fast track ( the two week NHS promise , but actually appointment came in 2days) series of tests on one day after some post menopause bleeding. Excellent service . Ended with a consultant meeting, during which he reviewed, said he thought it was fine but there was some slight thickening of the endrometrium. He wanted to biopsy and gave me the choice of then and there or to book in for it to be done under general anaesthetic. I didn’t feel under any pressure either way.

I just wanted the whole experience over and done with, despite hating the experience of smears - he said it was like a smear and then a nip.

The nurse held my hand and talked gently to me whilst I deep breathed. It was very much like a smear and then the ‘nip’ was more than I expected ( squeezed her hand a bit tight) but it was over very quickly.

On balance I’m still glad I didn’t have the GA, but maybe wished I’d known about this possibility so I could take some paracetamol whilst waiting to be ready to take the edge off. Timing might have been tricky to anticipate though.

Results all ok, btw.

As an aside, a friend is a mammographer and advised me years ago to take something half an hour before a mammogram appointment. Maybe it actually helps, maybe it’s psychological.

I tend to find anything they advise to take painkillers for beforehand is something I would prefer to be knocked out for

That makes me wince too. Surely there should be a better way, for things that are very likely to be painful?

Pethidine? Gas and Air?

Recently had both a biopsy (painful but just about tolerable) and then later a polyp removed (no way in hell I'd go through that again without sedation or GA).
They will try to talk your into doing it without pain relief, make out it is quick and not too bad. They are lying. And they know they are lying.
It's a bloody disgrace that women have to go through this.

Ask for sedation or a GA and stick to your guns.