Hysteroscopy & Polypectomy in Outpatients

[izmarie1984]

Hello,
Has anybody had a hysteroscopy with polyp removal in Outpatients with no anaesthetic? My local trust does not offer LA or GA by default, they only offer LA (cervical injections) if it is found that it is difficult to pass the scope through cervix or GA at a later date if the procedure could not be completed due to too much pain/too many pathologies found. I have 1 polyp (12mm x18mm as far as I can remember) inside uterus, which was discovered during an USS for mid cycle bleeding. I had 3 normal deliveries and I am in good health. What worries me is that I have retroverted (and bicornate) uterus, which makes USS quite difficult. However, I am fine with smears- I find them uncomfortable but bearable. Has anybody had hysteroscopy with polyp removal in OP with no anaesthesia? How did you tolerate it? I have waited for my appt for a long time, so even though I am scared of the pain, I don't want to wait any longer. Did you find the polyp removal itself very painful? Is cervical LA worth it? Many thanks in advance for all the replies x

I had this done a few weeks ago. It wasn't pleasant but it was bearable. I took paracetamol before and after the procedure. I had cervical LA but not sure how much that helped tbh. Luckily, it was over quickly!

I think this is done primarily in order to save money.

I have had polyps removed twice now and both times under GA. I would be extremely hesistant about having such done in Outpatients as well and without any form of anaethesia; infact I would insist on GA here.

Is there a NICE guideline on this? I'm sure I've seen a list of good reasons to ask for a GA for a hysteroscopy on the NHS website. I read around this a fair bit when I might have needed one a while back and my conclusion was many women manage with just discomfort but some find it excruciating. I had previously had one under GA (wasn't given a choice, my cervix is hard to find!). Luckily I didn't need one the second time, but I would have asked for GA. But I haven't had any children and I'm a big coward. A friend had one recently and hardly felt a thing. If you want to try it at the outpatients just be willing to say STOP if it gets too much.

Hello,
Many thanks for your replies- that is very helpful. I've rung the Admissions today and I am requesting the GA, due to my retroverted uterus, fibroids and hence difficult scans and smears- I hope they will look favourably on my request, I am quite scared of the OP appt with no anaesthetic, thanks again for your replies- it is good I am not on my own with this

I had this done and found it to be the most frightening and painful procedure I have ever had. I am usually pretty tough.

I would not recommend you have it in an outpatient setting without anaesthesia

Have a look here
www.hysteroscopyaction.org.uk/due-to-have-a-hysteroscopy/
I have had two and had the second under general anaesthetic because I was traumatised by the first. I had taken ibuprofen prior and it didn’t make any difference to the pain. However it was a quicker procedure than the one under general. My second gynaecologist told me not to put myself through that again when I needed to have a second 18 months later. I think a lot of hospitals want you to try and have it without pain relief as a cost saving exercise. I was told with my first one I would have to attend the hospital and find it unbearable rather than book it under general straight away. I think it’s a money saving exercise 🙄.

Hi SpringSparrow,
Have you had any polyps removed during your first one? I decided I am requesting the GA, rang the hospital and still waiting for a decision. I have spoken to a few friends- most of them had GA and were quite scared by the prospect of having just local or none at all. Due to my anatomical built, I have a feeling they would be struggling to get a clear picture causing me more pain with every move of the scope (as is the case with the TV USS). I am waiting for a call back and hopefully a positive decision. What I find interesting, is that private hospitals openly offer anaesthesia to all patients as a part of their options for the treatment. Thanks for all replies

I hope that you get to have it under GA. 🤞🏻. I just had a biopsy taken during my first one.

Thanks SpringSparrow. I will be on the phone to them next week. I have checked RCOG guidelines for hysteroscopy and it clearly says that the patient "may choose to have it done under GA". Our Trust's old leaflet also mentions it but the new reviewed leaflet just gives it onle little sentence at the end of a paragraph- but still something. So fingers crossed, maybe something will get decided nxt week. Have a good weekend (I am trying to occupy my thoughts with anything but the upcoming hysteroscopy...if at least the weather was good) X

I had a hysteroscopy and biopsy done in out patients two days ago.
I was very nervous going in, as I'd read horror stories online beforehand about it being a barbaric procedure without anaesthetic.
In the event, it was absolutely fine, and only mildly uncomfortable: I took paracetamol and ibuprofen an hour before my appointment time.
I wish I'd known how straightforward it would be, then I wouldn't have worried at all.
Get off the internet would be my advice!

I've had it done twice - one under local and one under GA. The local one was intense but the pain was fleeting. I had a biopsy taken then a second hysteroscopy a couple of weeks later because there multiple suspicious polyps although they were all benign.

I would not be overly distressed at the thought of going through it again but if I was given the choice I would choose GA.

I had a large pinky finger sized polyp hanging off my cervix removed last march with LA
I was scared but it was all over in 20 min no issue afterwards and biopsy fine
Def put your foot down and ask for GA or la
I didnt feel a thing with mine but everyone is different xx hugs

I had a hysteroscopy done and it was no worse than uncomfortable although not a polyp removal. I also have a retroverted uterus which was actually the reason I was having the examination - a previous ultrasound had been inconclusive because of the womb position.

In fact the consultant asked me at the start of the procedure "has anyone ever spoken to you about an abnormally shaped womb" which scared the hell out of me - luckily I got an all-clear anyway.

They were all incredibly nice and kept stressing that I could stop at any point - I was terrified because of what they might find but the actual procedure was fine - I've had much worse times at the dentist, to be honest.

I've been told by a nurse & midwife at with that LA in the cervix is more painful than a lot of the procedures it's used for.

Hi I had this done about 5 weeks ago it was fine had a bit of gas and air and chattered to the nurse who took my mind off it. Hubble got me a Starbucks when finished! I took a couple of days off to rest though to make sure it was healing well.

I had this with a big old polyp removed just before Christmas, I had a la and it was fine, little bit of discomfort but both the gynaecologist and the nurse were really lovely and supportive

Hope the procedure went well @izmarie1984
I had a polyp removal procedure today under deep sedation (not quite general anaesthetic). It went smoothly, I didn’t feel any pain, and I woke up from the sedation feeling very relaxed. I was quite apprehensive before going into the procedure but it was honestly fine under deep sedation.

I wouldn’t have wanted to do it without any sedation or anaesthetic though.

Hope your experience was positive and that the hospital honoured your wishes for anaesthetic.