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.

Having had IVF where they go into you to retrieve eggs as well as I have also had a cone biopsy with a local (chopped 1nch of my cervix off) - I would recommend the general. Is there a reason why you don't want a general? I like a bit of general - a reason to sleep without children asking me stuff!

There is one thing about locals - they have to stick a needle in you to administer the local.

I had a hysteroscopy recently with local, I didn’t feel the local at all and the scope only caused very minor discomfort but no pain whatsoever. It was much more pleasant than a dental checkup. I have had both vaginal and a c-sSection. You could try it and if too uncomfortable you could go back and have it done under spinal or general.

I've had two hysteroscopies with local and tolerated them fine. I have had two vaginal births so that may be why. The second was for polyp removal. I could see the whole procedure on a screen, which I understand would not suit many. Mostly it felt achy, with a couple of moments of crampy pain. Importantly, I didn't feel the actual removal (which I could see) at all. The discomfort was when she was dilating my cervix and when they pump water into my uterus. I was able to drive home half an hour later, so it suited me fine.

GA could only done in theatre by an anaesthetist. It's easier for anaesthetist to administer z spinal. I think you need to go back and ask as I am somewhat confused why a spinal wasn't mentioned

Not to derail the thread but how on earth do you get your little finger anywhere near your cervix?!

There is one thing about locals - they have to stick a needle in you to administer the local.

I've had local anaesthetic injections in my cervix and didn't even feel them.

And I don't have a particularly high pain threshold. I had local anaesthetic into my vagina when I needed stitches after giving birth and they really hurt! The cervix ones I was terrified about based on the previous ones, but I literally felt nothing.

Gosh none of this is reassuring at all.

I am terrified of the idea of GA. If I could go for spinal I would be that wasn’t offered. Maybe if I call other private hospitals? I am terrified so much so I want to leave it, does anyone know if you can do that or would that be stupid?

for context I have no real life support for this in terms of someone taking me etc and would have to really ask a friend and I don’t want to do that.

I had one a couple of weeks back. I opted for a general, as I had friends who had had it done “in clinic” and had found it very painful.

…as it was, I had a “saddle block”, a targeted spinal block, and didn’t feel a thing. Anaesthetist only made the decision on the day, ask if you can have one during your pre-op

@ExtraOnions how can I know beforehand though? I would feel ok with that as I had it for the c section. Do you think anywhere private would do that?

…you’ll have a pre-op appointment, ask there .. if they say “no” (which I doubt), you can change your mind.

I gathered, from my anaesthetist, the they prefer to give the spinal .. so hopefully you’ll be fine.

You are not the only person they will have seen, with a fear of a general.

@ExtraOnions thanks. Why dont they offer that instead of local then? Surely that is the obvious answer as you are properly numb but also awake?

@ExtraOnions when I say offer, I mean why hasn’t that happened to more people on this thread etc as it seems it is generally local or Ga

I had a hysteroscopy and I haven't had any babies or pregnancies.
It was very uncomfortable, like very very bad period pain.
But I didn't have a general anesthesia so I was able to drive myself back to work afterwards . I think with a general my recovery would have taken longer

Hi there I work with anaesthetists on a daily basis as a labour ward midwife. No anaesthetist in sound mind would give GA when a spinal would do. You need to go back to the doctor and ask wh a spinal is contraindicated for you and if there is any leeway about it

@Kosenrufugirl ok thank you. When I spoke to the private consultant he said it was either general privately with him or local at the hospital. He didn’t mention any other option it was literally like which of the two do you want?

I feel confused now as to why this wasn’t mentioned as i kept saying my worry with general was being asleep, so surely the answer is the spinal!!

Spinal is definitely the answer unless there are contraindications for example a rare situation when the woman's blood doesn't clot easily. You need to speak to the doctor and maybe get a 2nd opinion.

@Kosenrufugirl ok thank you. Do you think it’s safe to have a spinal privately? Or is it safer on the nhs?

I think both private and NHS is fine, I can't comment on the individual practioner/setting. If I had to choose between GA and local anaesthetic, I would personally choose local. I have never been under GA and I am not familiar with all their downsides. However, I have seen women waking after GA and I would hate to be in the same state of grogginess. My denstist told me some of her patients listen to hypnotherapy recordings to help with the nerves and it helps them. Maybe this is something for your to epxlore?

@Kosenrufugirl thank you. I asked about the spinal and they said they offer it privately so now I think I will do that… though I’m surprised nobody has said they’ve had it done that way except one poster!

If NHS isn't covering a spinal it's probably because the proposed procedure isn't thought to be painful/distressing enough to warrant a spinal. A spinal is guaranteed to remove all sensation however it does have some small risks of which you should be aware of. Royal College of Anaesthetists have information for patients leaflet Your Spinal Anaesthetic

I'm an anaesthetist. It's totally possible to do this with a spinal, and if you're otherwise well there's not much difference in overall risks between that and a GA. (@Kosenrufugirl this is a bit different from labour ward where we would have a preference for spinal. )

It would need to be booked on a proper theatre list with an anaesthetist though, same as if you were having a GA. The two main reasons I expect it hasn't been mentioned are:

1. Whoever you were talking to just didn't think of it - they're not an anaesthetist so don't know as much about the different options as we do!
2. For a quick day case procedure, you can usually go home sooner after a short GA, whereas a standard spinal lasts for 4-6 hours so you'd be in for longer (which might have logistical implications if you're e.g. in a day surgery unit which closes at 7pm or something). There are other, shorter acting spinal drugs but they aren't available everywhere.

It's a very reasonable thing to ask though, so @Summer20024 it's worth asking them. I'd be surprised if you need to go private just for that reason.

@SockQueen thank you. Is spinal considered riskier than GA then? I would need to drive later than day to collect my daughter, would that be allowed with a spinal?

The risks are different for either option, but if you are otherwise healthy, both are very safe. In obstetrics, GA is less safe, hence the preference for more spinal anaesthetics, but in other surgical specialties the difference is small to minimal.

You should not drive for 24 hours after either a spinal or a GA, so whichever you have, I'm afraid you will need to make other arrangements for your daughter that day.

I really believe it depends on the person, my dil has had it done 3 times, not had any children and she had no pain with it. My sister has had 5 children, vaginally and each of the 4 times she has had it done she needed a GA and she has a very high pain threshold. I've had it done 3 times, no pain, but have given birth vaginally. We are all shaped differently.