Recommendations for Private ERPC (London)?

[readingcat]

Can anyone recommend a private consultant/surgeon to carry out a safe and gentle ERPC? I'm worried about scarring etc so am keen to find someone London-based with a good reputation, but don't know where to start!

Sorry for your loss. There is no risk of scarring with an ERPC (this is a minor op in surgical terms, they use a flexible tube to suck out what remains of the lost pregnancy, and pass it via the natural gap in your cervix).
There is a very low risk of Ashermans syndrome. In terms of risk, you don't need a very ecperienced surgeon but a centre where they use ultrasound to "see" what they are doing. Hope that helps.

Mine was done within days of my loss on the NHS, but I hope these questions help you.

As what squitza said. Mine was done the day after my MMC was diagnosed and haven't had issues from it despite it being NHS x

Thanks for that. My understanding is that the risk is 1/200, a statistic I've read on a hospital handout and the Miscarriage Association website. Would love to be wrong!

They say less than 1/200 cases run the risk of perforation. This isn't Ashermans and can be fixed while you are under the general without long term problems.

Unfortunately, as it's not a 'cutting' operation, the influence of human skill (bar being gentle and using ultrasound) is limited. Things like how deep the placenta is embedded etc' are far more influential on success.

Good point re: perforation. However, the Asherman's Prevention website says: 'In summary of these publications [studies into Asherman's after ERPC] in peer-reviewed medical journals, the actual incidence of IUA after D&C for miscarriage ranges between 7.7% and 30%, and after a repeat procecure, up to 40%.'

Adrian Lower (consultant specialising in Asherman's and an acknowledged UK expert) says 'Estimates of the proportion of D&C procedures that lead to Asherman’s syndrome vary widely however the incidence is likely to be in the region of 5%'

I realise it isn't actively likely to happen, but the more I dig around on the internet, the more cases of Asherman's following ERPC I seem to find (admittedly unsurprising, given the internet).

It has to be said, the medical management stats aren't great - 50-75% success rate depending on which study you go with, so one might end up having an ERPC anyway.

Reading I've spoken to miscarriage specialists, and they (unlike the Asherman's website) place the risk far closer to the specialist's 1-5% than the other stats of 30%.

One reason being we no longer use D&C (and indeed ERPC is no longer referred to in the UK). I have not heard of any hospital using D&C in a long time, across many miscarriage forums and support groups. The modern process has no scraping involved, just a soft hose.