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?)

Really! No need to get so agressive, thankfully I live in Scotland so no prescription fees for me. I’ve not given birth either but have a nice evening 🙈

A very hard friend told me her hysteroscopy was hideously painful. I had my hysteroscopy done under GA. It's a very quick light GA and you're fully recovered within 24 hrs. I think it's outrageous they perform these procedures without GA.

A cervical polyp is ok to have with no anesthetic, although you get dragging period pain after it.

If you're having the hysteroscopy without GA and it hurts too badly, you can say it must be abandoned. Consultants are well used to this.

@Molone Thankyou for that

Well I’ve had a large baby and my cervix still wasn’t having any of it. I screamed like I was being burnt at the stake according to DH. GA should absolutely be available on request - I now insist on it for my annual hysteroscopy (needed because I have Lynch syndrome). It can’t be that bloody risky….

If it's an endometrial biopsy then they can be very very painful.

I have a fairly high pain threshold. First one I had wasn't great but not horrific. Second one the pain was off the chart. I wince when I think about it and was vomiting/shaking from the pain after. I've another booked for next week and am bloody dreading it.

A sample of tissue is cut out of the uterus. For some women the pain can be severe. Did you wake up today intending to minimize the experiences of others, or is that just your usual M.O.? 🤦‍♀️

@JenniferBooth I mean, honestly. 😢
Can women just stop shit-kicking other women?

I went for the same reasons as you op. Took painkillers before. The dr didn’t give a local as he said it wouldn’t help, removed a polyp (which was painful) then went back in again to do the biopsy. I was in so much pain I couldn’t speak and was just trying to breathe. I think maybe if I’d just had the polyp removed or just the biopsy it wouldn’t have been as awful. I was in tears and am never doing that again unless I’m knocked out.

Things like this have been on the news lately about the pain . Colcoscopy and such like.. how painful they are and women should be given local anaesthetic..
I'm sure there is a campaign going.
I certainly wouldn't have it done with local anaesthetic.
I've had so many procedures without and so much pain.. l never questioned it.

I've had many cannulas over the years, including arterial lines. Are you seriously suggesting that is more painful than a hysteroscopy/biopsy without anaesthetic?

Maybe you'd like to tell these women that it's 'just a nip':
www.hysteroscopyaction.org.uk/

Quite why you're choosing to minimise women's experiences of pain I've no idea. Just because you didn't find a procedure painful doesn't mean that other women are as lucky. Putting an instrument through the cervix can be unbearably painful for many women.

I've had a hysteroscopy and it was horrific. Incredibly painful and distressing. The gynaecologist removed a polyp from my cervix but was unable to biopsy the endometrium because I was so distressed. She said if I ever needed another it would have to be under GA.
Two years on and I need another hysteroscopy but don't want a GA because of the risks and the logistical nightmare of not being able to drive for at least 24 hours afterwards. I'm going to ask if Entonox is an option.

I had Entonox but by then I was so distressed that all it did was make me feel woozy and sick. I think if I'd been prepared for how painful it could be, I would have been calmer - the information leaflet beforehand hadn't even suggested taking painkillers in advance.

From your username @2023Enfys, am I right in thinking you're in Wales? It's where I had my procedure.

I’m so glad I found this thread - I’m currently waiting for a hysteroscopy for a biopsy. It’s not urgent so was looking at a couple of months wait anyway but since doing some reading about the procedure I’m going to ask for a GA. I know it’ll mean that I need to wait longer though.

I had a horrible gynae experience a few years ago and I’m terrified of being legs akimbo and crying in pain again.

Does anyone have any experience of insisting on a GA? How are you going to go about it OP? I can only imagine they’ll try and talk me out of it and I can be really passive so am a bit worried about getting talked around.

I have had 2 hysteroscopies and both times with GA. I live in France and it's standard procedure here, thank goodness, as I wouldn't have known I'd have to ask for a GA!

Good luck with your procedure, and health in general. I hope you are being supported by HCPs and friends/family. And the same to all posters, having hysteroscopies or biopsies or anything else.

I had this done privately recently and was just told it would be under GA, no other option offered. Tbh the GA knocked me for six and I felt really awful for about week afterwards so that was a downside, but I felt sore and bruised inside for quite a while too, so I don't think it would have been pleasant to be awake.

They should offer both options IMO, some women will obvs prefer one over the other for different reasons.

Isn't it mad how we're all so different? And there's no way to predict. I'm pretty stoic, but my hysteroscopy was up there with childbirth (in fact, worse, as you go from 0 to 60 in a few seconds). Won't need another, thank goodness, as it resulted in a hysterectomy.

No idea why they don't offer sedation, as they do for colonoscopies - surely that's better/safer/faster recovery than GA, but more effective than gas & air / paracetamol.

I think both options should be offered, it’s up to the patient if they are ok with any extra risks of a GA. It’s really unfair to take the choice away in my opinion and honestly reading these posts, If it was me personally I would willingly pay for a GA even if it meant a bank loan rather than potentially put myself through what others have described. It sounds barbaric. I understand some people might not suffer or find it bad but as someone who has suffered birth trauma in the past and also procedures that supposedly wouldn’t be too bad, it actually would harm my mental health to be subjected to such an experience again! To me, the risks of a GA would balance out favourably to that.

Hi all - quick update. I've just got through to the unit. I asked what actual procedure I was having (I wasn't told yesterday and it was a bit out of the blue).

The person on the phone was very nice, said the consultant will speak to you, put a small camera into your womb, have a look around, if needed, take a biopsy of the womb lining - all very standard procedure, won't take long.

I said "yes, but what's the name of the procedure' and he said 'hysteroscopy'.

I said thank you, I won't be having that without proper anaesthesia.

Immediately, the person said "that's absolutely fine, I'll note that. Come in for the appointment, the consultant will speak to you, we will ask you to sign a consent form and an appointment will be made for you to have it under GA on a scheduled day. No problem at all"

So this is great news, but given that the person on the phone clearly had the knowledge to confirm this, it didn't surprise them in the least, and they have a system for it, why wasn't it offered to me as an option in the first place?

Thank you all so much for your advice, I think you've made a real difference to me.

That's great news. But not such great news that they tried to minimise it initially.

I did the same as you- the consultant phoned me and when I said I wanted a GA she said "you don't actually need a hysteroscopy so we will discharge you".

I'm now being referred again as the post menopausal bleeding has continued. So I will fight for GA.

That's really worrying, @Movinghouseatlast - it's either needed or not, isn't it. You insisting on your rights shouldn't have any bearing.

I hope you get your GA and some answers quickly x

Many procedures are initially offered with local anaesthetic instead of general due to the increased risk from GA. I’ll always have local over GA due to the increased risk and deal with any discomfort as that’s preferable to me. I get why some people would rather have a GA though.

Good news, OP, glad they didn't minimise your concerns.

So glad to read this update. Would you mind updating after your appointment to let us know how it went when you meet them face to face and say that you want a GA please?

I’m expecting some attempt to persuade me to change my mind so it would be really interesting to know your experience.

In many countries it's routine to do hysteroscopy under GA. 'In office' hysteroscopy is relatively new and many women suffer extreme pain. Some have no problems at all - lucky them!

GA is actually very safe.
It's barbaric what they make women endure. No way would I do any procedure like that without either GA or sedation.