Polyps, hysteroscopy and high blood pressure

[Dailymailbastards]

I had an outpatient hysteroscopy this week for postmenopausal bleeding and I have at least one polyp which needs removing. Surgery is booked for 12 days time. However they discovered I have really high blood pressure so they can't operate until that is lowered.

I'm having a 24hr blood pressure machine fitted this afternoon and the GP will get the results on Monday. Which will leave a week before surgery date and I'm concerned my BP won't be low enough.

This is being done under the 2 week wait for suspected cancers, so the anxiety of that isn't helping my BP.

How long should it take for the medication to start Working?
Can I request the operation to be done via spinal block with sedative?

BP medication will lower it after taking the first dose.
I was advised to have a hysterscopy last year and asked whether it could be done by spinal block. It could be, but I think they prefer to do GA as it can be done as day case. Not sure about a polyp removal though.

Sorry just realised you have already had a hysterscopy.
I know hysterectomy can be done under spinal block and I would guess polyp removal could be also. I just think they prefer to put patients under GA.

Polyps are very common and rarely cancerous- if you google this or look at the NHS information i think it will say something like 90%+ are benign and don't even need treating unless they cause symptoms.

This is only my opinion but I think the most important thing is to control your BP before you have a GA, even if it takes a while. Has any cause been found for your high BP and are you and your dr sure it's not white coat syndrome? What kind of readings are you getting at home?

It's worth asking about not having a GA- spinal block seems a bit OTT anyway (imo) because it's common enough to have a hysteroscopy with out any pain relief and a biopsy done. If your polyps are small they may be able to deal with them with only a local anaesthetic in your cervix if you wanted that.

NK- (what along username!) I had a hysteroscopy and biopsy with nothing. I didn't want a GA or a local and my consultant and I discussed this beforehand. It was painless and there is now way based on my own experience I'd recommend a full GA for what is a fairly minor procedure- not much worse than a smear and not painful if you have a good dr.

Keep meaning to change that?
I refused the hysterscopy, gynaecologist suggested it because , according to him I overused Vagifem! I was not experiencing any bleeding issues so felt it was completely unnecessary.

NICE guidelines say no endometrial sampling or investigations are necessary with vaginal oestrogen (unless someone has symptoms.)

Yes, that is why I refused. He had the most awful intimidating manner I have seen for a long time and I expect some of his patients go along with unnecessary procedures because they don't like to question.

Given the shortage of cash in the NHS now it beggars belief that a consultant is not aware of the NICE guidelines and is wasting money as well as putting women through investigations that are unnecessary. How do they got away with it all???

I went private after I saw him and the meno specialist I saw was truely shocked at what I told her, she asked if he was genuine!
I also think it is unethical to do procedures on patients that are not needed.

I ended up not having the 24hr BP test as the machine was faulty, I saw the on call GP and he has given me a beta blocker called bisprolol and my BP has already dropped. My bp is a bit on the high side but the GP feels there is an element of white coat hypertension.

I had the biopsy taken in the outpatient clinic and the surgery is for the full removal. I'm dreading it but need it done to deal with the bleeding.

Daily There is a thread / post on the forum of www.menopausematters.co.uk- the forum section is at the top of the menu on the site -from someone who has just had this procedure- hysteroscopy and removal of a polyp without any anaesthesia at all. Sh was offered it on the spot and agreed- might be worth you reading it. She says it was absolutely fine. You don't need to be a member of MM to read the forum but you do have to join to post.

I also have a bleeding polyp. I went to see my GP about mid cycle bleeding and when she put in the speculum to investigate my cervix there was a large polyp poking through.
Now waiting a gynaecologist consultation but it is very uncomfortable and bleeding steadily.

Just looking for some sympathy!
Help.

Ouch, timetogetup. That does sound painful.
Polly, thanks for that, it's really reassuring to know I could have them removed without anaesthetic.

My BP is now low enough, at least at home so hopefully all will be OK at the preop on Wednesday.

If you pop onto the Menopause Matters forum there is post 'Waiting for biopsy results' a few threads down on the 'All things menopause' part of the forum. Someone has posted about having a polyp removed without a GA.

After very heavy bleeding all weekend my GP has put me on Tranexamic Acid tablets to attempt to stop the bleeding and fast tracked me to see a Gynaecology consultant within 10 days.

I spent the weekend on the sofa dripping blood and working my way through a pack of maternity pads.

Thoroughly miserable.

Good luck for the Pre Op Dailymail

It's my procedure tomorrow and I'm very stressed by the thought.
I need to have a general anaesthetic because there's the possibility of it being more than a hysteroscopy. The lining is 14mm so they are taking a biopsy, and I've signed consent for a possible hysterectomy if they find anything suspicious.
I have a 18 month old badly healed spinal fracture so the anaesthetist won't risk a spinal block.
I just want it to be Over!

I'm sorry you are stressed.

In your shoes, I'd not have consented to a hysterectomy without having tried other treatments first.
For a start, they won't have the results of the biopsy there and then during the op. If you are still having periods, a lining of 14mm is not unusual, depending where you are in the cycle and during peri when cycles can be longer, it's not necessarily an issue.

If you have hyperplasia, there are other treatments- progestogens for 3-6 months (tablets.)

There are also several types of hyperplasia from simple to complex and with or without cancerous changes for each.

I feel very angry for you that you have been rushed into consenting for an operation that's possible without having had a full consultation and all the options discussed.

You do not HAVE to consent to anything, and you are within your rights to change your mind right up to when you are taken to theatre.

Quick update.

I had the polyp removal and cutterage yesterday under general anaesthetic, I didn't consent to a hysterectomy.

I'm two years post menopausal so the 14mm uterine lining was abnormal.

I have to wait for the biopsy results now, the surgeon doesn't feel it's cancerous which is a relief.

Unfortunately they didn't get all the polyps so I have to go back to outpatients to have something called truclear.

I'm uncomfortable today, but keeping pain relief topped up.

Glad you are ok. I wonder why he couldn't remove all the polyps?

Hopefully they will get a treatment plan sorted for you.

Have they given any reasons for the lining build up? It's possible in some women that cycles that are incomplete ( around menopause) cause the lining to build up (and no period) because the progesterone part of the cycle doesn't happen. So you get the build up with oestrogen, but no ovulation and no progesterone to complete the cycle.

The other main risk factor for hyperplasia is being overweight because fat cells make estrogen and stimulate the lining.

I hope you feel better soon and it's all resolved.

Hello just in case anyone is worried or really concerned about either having a Hysteroscopy or Polyp removal I would like to offer some reassurance. I've had 3 seperate Hysteroscopy procedures, first was done as an investigation procedure , I had this done without any pain relief in clinic. It really isn't bad please do not listen to some of the rubbish about it on internet. The next 2 Hysteroscopies I had for polyp removal. Due to a large polyp I was offered local pain relief injected into cervix awake whole time , again not too painful, just keep calm, breath steady and it really is fine. I even watched on the monitor while the big beast was being cut away. I do think the equipment looks scary but the new small scopes are so amazing and I had the hystoscophy shaver which has a fantastic painless way of removing polyps. I've also had 3 biopsies and a further polyp removed. Be reasured nearly all polyps are benign and extremely rare to be cancerous. They are an overgrowth of cells caused by Estrogen imbalance hence very common in post menopause like me, I'm 56. Please do not be scared, I'm no super human and was terrified after seeing horror stories on internet. Keep calm, the equipment is amazing new scopes are under 4mm and really are almost painless. I will confess that all 3 biopsies I had done were painful but very quick, feels like a sharp cut tug but over in seconds. If you have a woman Dr doing the procedures they tend to be quite caring. Although I've had both m & f doctors for my procedures. Also had ovaries and tubes removed. Polyps can be very painful when they grow large, most info doesn't say this but I have had lots of pain, neuro pain sensations too and my consultant who I've been seeing past 2 years said pain is common so do not think you have cancer, we all worry about this, pain is common but cancer is not. Most will be benign, I had multioculated cyst with solid septations, scary type but it was benign. After advice had ovaries and tubes removed due to my age. Please do not be scared it is fine to have a Hysteroscopy while being awake, it's not that bad at all. I feel so much better without constant pain these beasties gave me. Hope this can reasure and helps in some way for anyone scared.