To worry about this procedure after doctor’s comment about birth? (Polyp)

[Summer20024]

I need a uterine polyp removed. I was told I could have it under general or local but as I had had a c section I probably wouldn’t cope with local as I wouldn’t cope with the pain? I suppose implying I haven’t suffered labour pains before?

I don’t want general and now I’m petrified of local too. Has anyone got experience of this? I am lucky I can go privately but apparently most private hospitals only offer it under general. I don’t know what to do, feel really overwhelmed by it all.

I'm not by any.means medical.person but my guess would be that it's nothing to do with your tolerance to pain but the possibility that, having had abdominal surgery for a caesarian section, there may be adhesions etc which might make the op a bit more complex than usual so they think a general would be more appropriate

YNBU to be anxious about the procedure. But imho I think the concern about whether it is under local or general is a red herring and it’s just what you are focussing your anxiety on. It’s a horrible experience facing a procedure in hospital with all the uncertainties that that brings and it’s ok to not look forward to it.

Either way I hope it goes smoothly and your recovery is quick. Draw on the support you have from family and friends.

What @Svolvaer said rings true.

I would imagine it's because they're going through your cervix isn't it? And you've not had a vaginal birth. I don't think it's to do with labour pains.

C-sections cause adhesions which is why clinicians like to avoid when possible.

At least one of the reasons.

@DancingPhantomsOnTheTerrace why does that matter though?

He did specifically say it was entirely up to me as to general or local and didn’t mention the c section being a factor other than I hadn’t experienced pain levels like labour

@vincettenoir thanks. There are no adhesions showing following the scan

@Summer20024 I was just under the impression that hysteroscopies were considered more painful if you hadn't had a vaginal birth, like other things do to with the cervix such as IUD insertion. I assumed it was do to with the cervix being, I don't know, more open maybe. Or more easily opened.

This is why - its also the reason they say its more painful to have a coil fitted if you havent given birth - your cervix will be harder to open and it could be more painful

Its not a slight on your pain thresholds its just that typically it will hurt more as it hasnt had to open before

I don't understand why you can't do under spinal anaesthetic. You won't feel any pain from waist down under spinal.

@Kosenrufugirl that didn’t come up at all actually. It was local or GA

I had a polyp removed last year. The consultant who made the appointment said it would be under local but in theatre and I was terrified (I have had previous hysteroscopies). However when I got to the appointment the anaesthetist was brilliant and very reassuring and explained that the options in theatre were much more effective than in the clinic. But then I saw the consultant who was doing the procedure and he said that I could have a spinal anaesthetic and that was the best of both worlds - I lay back behind the screen and didn't feel a thing.

I had mine removed under local anaesthetic. It was very uncomfortable but not comparable to giving birth. You need to ask them to confirm exactly why they think it will be too painful for you.

@Alwayswonderedwhy he didn’t say it would be too painful, he just was discussing what people’s pain thresholds were etc. he was quite happy to book in the local. I’m just scared now.

I had one removed under local. I was told that 3 vaginal births would work in my favour - not because of pain issues.

@SonicTheHodgeheg how does it work in your favour?

do you think I should go with general then? I’m really scared

Is the pain during or after the procedure?

Well I can say as someone that has had 3 vaginal births my cervix has DEFINITELY change massively due to that.

It use to be a tiny pin prick before having kids and has stretched with each birth but can practically fit my whole little finger in it now.

If you didn't dilate with your C-section its likely still very tight and I would hazard and educated guess it will be greatly uncomfortable to have to 'stretch it' to ram stuff up it.

I think they may enter your womb via the cervix. If the cervix has previously dilated enough for a vaginal birth, it would be easier for medical instruments to enter the womb via that route surely than if you'd had a cesarean where the cervix would not have been stretched?
Phone the department on your appointment letter and ask if you can speak to a nurse or doctor about the procedure.

Ok this is making me feel worse! @HmmWhatNameToHave and @housethatbuiltme won’t local anaesthetic mean I won’t feel it though? Only afterwards it might hurt?

I had a hysteroscopy before kids but offered no anaesthetic at all and it was worse than giving birth.

After giving birth I've since had another and a uterine polyp removed, again with no anaesthetic and whilst uncomfortable it wasn't in the same league.

Now thinking my health trust is bit crap offering no pain relief.

Hysteroscopy, which is part of the procedure, can cause severe pain in about a third of patients, and the risk is higher if you have not given birth vaginally. Local anaesthetic will only have an impact on cervical pain, not uterine pain, which has a different nerve route. You would still feel the uterine polyp removal. Have you considered IV sedation with analgesia? You wouldn't be aware of it happening, and it's a safer option than GA, although general anaesthetic is really quite low risk these days. I had an extremely painful hysteroscopy and was traumatised by it. There's no way I would have a hysteroscopy again without a GA or sedation, and I've given birth vaginally twice. You can see the Campaign Against Painful Hysteroscopy website for more information or support.

I had a a endometrial biopsy with no anaesthetic and that was bad. Dr told me some women told him it was worse than childbirth though I had nothing to compare it to as I’ve not been through childbirth, I’d previously had a polyp removed under general. I would go for the general if I were you.

Having your cervix opened if a baby hasn't been through it is more painful. Had coils fitted before and after baby, massive difference in pain.