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

140 replies

CantFindTheBeat · 21/05/2024 11:44

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?)

OP posts:
Disturbia81 · 23/05/2024 10:01

Good update OP but SHOCKING it wasn't offered initially.

BrassicaBabe · 23/05/2024 10:32

coralpinkduckegg · 21/05/2024 12:22

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.

Abso-fecking-luty!

TreesWelliesKnees · 23/05/2024 11:05

Would Fentanyl up the nose work? My dd (age 10) had it for a bad bone break and it was spectacularly effective. She remembers nothing of the bone being reset - she was absolutely off her head. Not sure if it would work the same for soft tissue though. But if it did then it could still be done 'in office' without the risks and costs of GA. There are so many options for good pain relief - there must be a better way.

Waiting to hear if I need one so watching closely.

Interested in this thread?

Then you might like threads about these subjects:

CantFindTheBeat · 23/05/2024 18:22

Thank you for the comments and support everyone.

@Stickersandlollipops - I certainly will.

The appointment is on Sunday. I will update as soon as I can.

I'm actually planning what I wear to ensure I look business-like and confident. Ridiculous really but I feel I need to boost myself up to ensure I don't get pressured.

I am really hoping that the consultant says it's not necessary anyway. I had an internal scan 10 days ago. I know the sonographers aren't expected to share bad news, but she was very open, and said that the womb lining look fine, nice and thin, and she could see a tiny follicle that looked like I'd ovulated, which is apparently not impossible when you're on HRT.

We even joked that maybe it was time for another baby (it's definitely not!).

I imagine the consultant hasn't seen the scan so hopefully they can see from that if they think they need to explore further.

The paperwork has come through today. Again, it says 'we strongly recommend you take some pain relief 20 minutes before your appointment'.

It also says 'No general anaesthesia is required, and 2 out of 10 ladies require some local anaesthetic in the cervix. We may take a sample of tissue from the uterus when you may experience some period-like pains'.

I will update after the appointment.

OP posts:
Disturbia81 · 25/05/2024 10:24

CantFindTheBeat · 23/05/2024 18:22

Thank you for the comments and support everyone.

@Stickersandlollipops - I certainly will.

The appointment is on Sunday. I will update as soon as I can.

I'm actually planning what I wear to ensure I look business-like and confident. Ridiculous really but I feel I need to boost myself up to ensure I don't get pressured.

I am really hoping that the consultant says it's not necessary anyway. I had an internal scan 10 days ago. I know the sonographers aren't expected to share bad news, but she was very open, and said that the womb lining look fine, nice and thin, and she could see a tiny follicle that looked like I'd ovulated, which is apparently not impossible when you're on HRT.

We even joked that maybe it was time for another baby (it's definitely not!).

I imagine the consultant hasn't seen the scan so hopefully they can see from that if they think they need to explore further.

The paperwork has come through today. Again, it says 'we strongly recommend you take some pain relief 20 minutes before your appointment'.

It also says 'No general anaesthesia is required, and 2 out of 10 ladies require some local anaesthetic in the cervix. We may take a sample of tissue from the uterus when you may experience some period-like pains'.

I will update after the appointment.

That last paragraph is utter bullshit, can't believe they lie to women like that. Then you feel weak for asking

Stickersandlollipops · 25/05/2024 11:50

I’ve just been told that as my biopsy isn’t considered urgent, if I want a GA, I’ll have to wait 6 months.

Either 6 weeks to go through a potentially tremendously painful procedure, or six months to have no pain but be left with the (admittedly low but still unsettling) wait for biopsy results for six months.

How is this okay?

Portfun24 · 25/05/2024 11:52

I had a lletz procedure and biopsy last September and I honestly never felt a thing and pain after was very minimal. Like 1/10 for couple hours then fine. I just took ibuprofen and paracetamol for a couple of days. My step mum had a biopsy on Monday and said she was also completely fine after. Good luck, youl be okay.

BonzoGates · 25/05/2024 11:56

Stickersandlollipops · 25/05/2024 11:50

I’ve just been told that as my biopsy isn’t considered urgent, if I want a GA, I’ll have to wait 6 months.

Either 6 weeks to go through a potentially tremendously painful procedure, or six months to have no pain but be left with the (admittedly low but still unsettling) wait for biopsy results for six months.

How is this okay?

That's not an option, it's a punishment for exercising your right to a choice. It's in the RCOG guideline that you can choose GA.

I had a sexual assault as a child and would prefer a GA if I ever had to have this procedure. The 'vocal local' from the nurses would additionally remind me if the cajoling I endure during the assault.

Can you contact the Campaign for Hysteroscopy action on this? Is there a similar wait if they try the procedure and can't finish it?

I'm furious for you

tartancladpjs · 25/05/2024 11:58

Why can't they offer spinals? I'm not medically trained but we have a massive gap in pain relief here.

We have nurofen which does nothing... then I would think logically the next options would be sedation, spinals, gas and air maybe opioids.

Before we go to GA, but I've never heard the middle options being mentioned.

Good luck OP

BonzoGates · 25/05/2024 12:00

The British Society for Gynaecological Endoscopy published this statement in December 2018:

"Diagnostic hysteroscopy is a commonly performed investigation; it is safe and of short duration. Most women are able to have the procedure in an outpatient setting, with or without local anaesthesia, and find it convenient and acceptable. However, it is important that women are offered, from the outset, the choice of having the procedure performed as a day case procedure under general or regional anaesthetic. Some centres are also able to offer a conscious sedation service in a safe and monitored environment. It is important that the procedure is stopped if a woman finds the outpatient experience too painful for it to be continued. This may be at the request of the patient or nursing staff in attendance, or at the discretion of the clinician performing the investigation

Upthejunctionandroundthebend · 25/05/2024 12:01

I had a hysterscopy to remove polyps, with local anaesthetic, and it was painless. I was astonished as I'm a real wimp and have never had children or a coil. They offered to stop during the procedure if I asked, and the would arrange for a general anaesthetic instead. I was late 50s and had been bleeding post menopause.8

BonzoGates · 25/05/2024 12:04

acrobat.adobe.com/id/urn:aaid:sc:EU:7a0fe072-eb5d-4041-9ad1-0d70dcd3eeb4

Are there alternatives to having outpatient hysteroscopy? There may be other things to consider when deciding whether OPH is the right choice for you, such as: • if you faint during your periods because of pain • if you have experienced severe pain during a previous vaginal examination • if you have experienced difficult or painful cervical smears • if you have had any previous traumatic experience that might make the procedure difficult for you • if you do not wish to have this examination when awake. You may choose to have your hysteroscopy with either a general or spinal anaesthetic. This will be done in an operating theatre, usually as a daycase procedure. You can discuss this option with your healthcare professional. The risks and complications are lower when hysteroscopy is done as an outpatient procedure rather than under anaesthesia.

mumtoadhdadult · 25/05/2024 12:58

Partner will have a biopsy for prostate cancer and that involves a probe up his bum with prongs to go through the bowel wall to take a sample of the prostate.

Local anaesthetic.

It's not only women...

linelgreen · 25/05/2024 14:57

You have the right to request this to be done under GA please insist on it.

JenniferBooth · 25/05/2024 15:12

Stickersandlollipops · 25/05/2024 11:50

I’ve just been told that as my biopsy isn’t considered urgent, if I want a GA, I’ll have to wait 6 months.

Either 6 weeks to go through a potentially tremendously painful procedure, or six months to have no pain but be left with the (admittedly low but still unsettling) wait for biopsy results for six months.

How is this okay?

If the NHS want to be hated they are going the right way about it

JenniferBooth · 25/05/2024 15:12

mumtoadhdadult · 25/05/2024 12:58

Partner will have a biopsy for prostate cancer and that involves a probe up his bum with prongs to go through the bowel wall to take a sample of the prostate.

Local anaesthetic.

It's not only women...

thats because its a ££££££££££ saving excersise

Stickersandlollipops · 25/05/2024 16:20

BonzoGates · 25/05/2024 11:56

That's not an option, it's a punishment for exercising your right to a choice. It's in the RCOG guideline that you can choose GA.

I had a sexual assault as a child and would prefer a GA if I ever had to have this procedure. The 'vocal local' from the nurses would additionally remind me if the cajoling I endure during the assault.

Can you contact the Campaign for Hysteroscopy action on this? Is there a similar wait if they try the procedure and can't finish it?

I'm furious for you

I feel so confused. I really don’t want to do the procedure awake. I find smears very uncomfortable and sometimes painful, I’m just dreading this.

I’d also quite like to know if there’s anything wrong with me before next year!

They've said that if they thought it was sinister then I’d be seen very quickly, therefore they mustn’t think it is as I’m on a 6-8 week wait now. There is obviously still a risk of some degree otherwise why bother doing the biopsy at all?

I don’t want to wait until next year to risk being told “it’s cancer and if only we’d found it sooner it wouldn’t have spread”. Likewise, I cry almost every time I think about the procedure and am legitimately terrified.

This is a horrible decision to make.

JenniferBooth · 25/05/2024 16:37

Election been called. Just saying

AllTheChaos · 25/05/2024 16:43

I am so jealous who have no problems with smear tests! I find them incredibly painful, to the point of uncontrollable sobbing (when am normally pretty stoic), and usually bleed like fury for a week or so afterwards. Then the bleeding usually turns out to have contaminated the sample, so I end up being pulled back in for another procedure anyway.

Onemonkeyand3wisemen · 25/05/2024 16:52

tartancladpjs · 25/05/2024 11:58

Why can't they offer spinals? I'm not medically trained but we have a massive gap in pain relief here.

We have nurofen which does nothing... then I would think logically the next options would be sedation, spinals, gas and air maybe opioids.

Before we go to GA, but I've never heard the middle options being mentioned.

Good luck OP

I had spinals in Labour they didn't work.

Liliee · 25/05/2024 17:07

I had a hysteroscopy and uterine biopsy with no pain relief at all. It wasn't definite until I got there, but I was kind of hustled into it. It was horrific. I couldn't stop myself crying out. It also hurt for days after and I kept having little flashbacks to the pain.

I was confused as I had never heard anything about this procedure and thought maybe I was overly sensitive. Until I saw the hysteroscopy campaign on Twitter.

Uninformed consent is not proper consent. We are lied to and so can't consent to the procedure as it actually is.

I've had two colonoscopies with gas and air and no issues at all. Would happily have more if needed. I would never have another hysteroscopy without GA.

Disturbia81 · 25/05/2024 17:11

AllTheChaos · 25/05/2024 16:43

I am so jealous who have no problems with smear tests! I find them incredibly painful, to the point of uncontrollable sobbing (when am normally pretty stoic), and usually bleed like fury for a week or so afterwards. Then the bleeding usually turns out to have contaminated the sample, so I end up being pulled back in for another procedure anyway.

Yeah any procedure involving instruments/fingers really hurts me. I nearly jumped off the examination bed getting my cervix measured

RoobarbAndMustard · 25/05/2024 18:18

mumtoadhdadult · 25/05/2024 12:58

Partner will have a biopsy for prostate cancer and that involves a probe up his bum with prongs to go through the bowel wall to take a sample of the prostate.

Local anaesthetic.

It's not only women...

Same for my DH. They gave him 1 antibiotic before the biopsy and one to take after.
Within a week he had a terrible UTI, urinary retention and sepsis all at the beginning of the first lockdown. Ended up being admitted overnight twice for IV antibiotics and had a catheter first a month. That could have killed him.

Liliee · 25/05/2024 20:55

JenniferBooth · 25/05/2024 16:37

Election been called. Just saying

Wrong thread?

CantFindTheBeat · 26/05/2024 12:03

Thank you for everyone’s posts on this thread. Again, I’m so sorry for all who’ve had awful experiences when going in for these procedures and not being given the right options for anaesthesia, listened to or even forced to continue against their will. It’s truly frightening and I’m grateful to everyone who shared their story.

I do have to say that in my case, I can’t fault the response regarding the NHS referrals and speed of appointments and the sense of urgency on investigating my post-menopausal bleeding – that has been phenomenal. My issues are with the minimising of the procedure and not providing information on choices I have.

So to update on this morning’s appointment – it’s massively long, but I wanted to get everything in.

In good news for me, the consultant had the scan results, explained what was found, said that all was normal, post-menopausal bleeding is reasonably common within 6-8 months of going on HRT, and no further investigations needed at this time. A big relief.

I thanked her and said that I was very pleased, and that I had hoped that would be the case after speaking to the sonographer myself.

I then asked if I HAD have needed a hysteroscopy, would I have been able to have a general anaesthetic? She said absolutely, they always talk through all anaesthesia options, offer GA for people who want it, and they even sometimes do smears under GA.

So I then said I wanted to share with her my experience of the process and get her opinion on it.

I described how I was called on Tuesday and asked to come in for an appointment, told to take painkillers ahead of the appointment, that consultant would put a camera into my uterus and take a sample of womb lining., and when I questioned no anaesthetic, the response was, ‘I know, the things we women have to put up with, eh!,

I described how when I phoned the next day for clarity on the procedure, I was told it was a simple process, only takes a few minutes, nothing to worry about, yet when I asked about GA I was told that was absolutely fine and definitely an option.

I told her how the information emailed said no GA was needed, although ‘2 out of 10 ladies might need a local anaesthetic’.

I said that I had canvassed women in my network, who had reported having a hysteroscopy, that some had little or no discomfort, whereas others had reported a scale of painful, to excruciating and unbearable.

She said yes, she would agree with that, and that's when she said that's why they offer GAs, and that's the reason they can also do GAs for smears as they can be so painful for some.

I said that had I listened to that first phone call, as I’m sure most people would, I’d have come in today having taken pain killers, expecting to have an invasive procedure with no anaesthesia, which she agreed would have been wrong.

Long story short – she said she was sorry that telephone staff had not been clear on this from the outset, their procedures needed looking at, she would raise it at a consultants meeting that is happening next week, and suggest a review.

She was great. I was listened to, and I feel some action may be taken.

I’m going to email PALS with this too, to 'get it on record' , along with copies of the paperwork so show that what the consultant thinks is happening, isn't, to formally strengthen the case.

So a good outcome for me, I feel glad I went in armed with knowledge acquired via links on this thread that I could deliver in an informed way.

I was listened to, and maybe my challenge will possibly make things a little bit easier for other women at that clinic in future.

Good luck to everyone going through similar.

OP posts: