Why is conscious sedation not routinely offered for a hysteroscopy?

[MaMelon]

I've been referred for one of these beauties and have been doing my research, as you do. There's absolutely no way I'm "tolerating" such a procedure (to quote the Dr I spoke to) so have dug my heels in and they've taken me off the outpatients list and have put me onto the GA list - I have to see another Dr first to discuss this, but it will happen. I am not going through it without anaesthetic - for several reasons.

I asked the gynae secretary why conscious sedation isn't offered as standard as it is in other clinics such as colonoscopy or endoscopy, but she didn't know.

Anyone know why? It seems bonkers that it's either outpatient (possibly with local - although from what I've read this isn't effective)or a GA, with nothing in between.

There must be a lot of variation by NHS trust. When I had a hysteroscopy it was under a GA - I wasn’t even given an alternative option (which was fine by me). But when I had a colonoscopy the expectation/norm was that I’d have it without GA/sedation and then be given sedation if need during the procedure - which I most definitely did!

I had a hysteroscopy, biopsy and polyp removal with no pain relief. It was the most horrific experience of my life.

Never. Again.

Boards and Trusts (Boards are what we have here in Scotland - because health is devolved there’s no UK health service) all seem to have different approaches, which is bizarre. You’d think there would be a standard needs-based clinical pathway, especially for something which is known to cause significant pain in up to 25% of women

Anyway, I spoke to my GP to say that I really wasn’t happy with the idea of a hysteroscopy based on one heavy period and one tiny bit of post sex bleeding (haven’t had either since - but at 52 I would expect my periods to be a heavier, and possibly heavier post covid vaccine in line with many thousands of other women). She completely agreed with me so is writing to the Consultant to see if there is an alternative

@AnyFucker

I had a hysteroscopy, biopsy and polyp removal with no pain relief. It was the most horrific experience of my life.

Never. Again.

I agree totally - I’ve had the same and it was a truly barbaric experience- far far worse then having a coil put it in or anything!

I would insist on a GA after 3 friend's horrific experiences.

I had a hysteroscopy, biopsy and polyp removal with no pain relief. It was the most horrific experience of my life

Yep - that’s exactly what I’m worried about. I had a small polyp last year which had disappeared on my third scan. Now they seem to think it’s back (without checking on a scan) and as I’ve had three children I should be able to “tolerate “ it.

As DH rightly said - people used to “tolerate” amputation without anaesthetic because there was none on offer.

Nope - it ain’t happening.

Why don’t they offer gas and air? I was wondering this myself recently.

I’ve had 2 with just paracetamol too and also had a colonoscopy without any sedation.

I agree. I got through three labours on just gas and air, including a ventouse - that nipped a bit! - which was amazing because I need diazepam to get me through a filling. If gas and air can get women through labour why don’t they offer it for hysteroscopies?

I had one with an endoscopy and couldn’t feel it.

I asked an experienced rgn at work & she said it wasn’t anything major. I had ga for my polyp removal and was ill for 10 days.

My mum had an endoscopy without sedation and found it absolutely awful. She was a very stoic woman but was really upset by it - she said she would never put herself through that again. BIL had one snd was advised to have it by his Dr.

There’s no consistency at all .

You won’t like this but mental attitude makes a huge difference.

I was told it was ok, you’ve been told it’s awful.

I haven’t had kids but I’ve had a lot of gynae investigations with no pain.

Oh no - not having the ‘women are imagining it’ line. Stop right now.

Good for you that it didn’t hurt - lucky you.

🤷🏻‍♀️ You can always tell a nervous patient when they walk in.

They suffer more every time. I work in healthcare, I was more nervous of dying under GA. Your very wound up about this.

Seriously - stop. You are not contributing anything positive to this at all. You have no fucking idea why I don’t it without sedation so enough.

Oh - and I work in healthcare too. Big deal.

Mine hurt a lot. To be fair I had c-sections, so they said it would be worse. I also didn’t have pain relief, but it was all quite short-lived.

I had my first hysteroscopy without any pain relief , during which they removed a polyp. It was done at what I thought would be a routine outpatient appointment to discuss treatment options . It went from we'll just have a look with a vaginal ultrasound , to let's just sort this out, so no time to discuss/ consider options or to be given pain relief , just straight to undergoing the procedure. It was agony, I left the appointment to return to work and remember phoning my mum from the hospital sobbing. I wasn't fit to drive back to work, but hadn't any other options.
The second hysteroscopy was done under a general after I refused to repeat the procedure without having a general anaesthetic.
This was also in Glasgow.

Why ask if you just want to push an agenda then?. GA is relatively safe but still dangerous.

How would a Band 4 gynae secretary know why sedation isn’t offered?. Poor woman just wants to get you booked in one way or another.

I am supposed to have one of these next week. Thanks for opening my eyes. I will phone the secretary, after reading your experiences .

1fluffydoodle oh that sounds awful Unfortunately it also sounds all too familiar from the research I did. I was due to get mine in Lothian, will see what comes of my discussion with the Consultant.

Was anyone offered sedation or gas and air as an alternative to GA (or nothing)?

I was told I needed a general anaesthetic for the endometrial ablation which was recommended after these procedures. I believe that this is something which is routinely under local.
Hope everything works out well

Thank you

My mum had one a few were ago, and said it was fine. No worse than a smear test.

No worse than a smear test

Assuming you find smears ok That’s one of the several reasons why I’m keen to have an alternative option.

I think everyone is different.
Personally I've never had a problem with smear tests & I've done child birth without drugs ... so I was surprised by my reaction.
I wasn't even anxious as I hadn't heard of a hysteroscopy beforehand.

I would say if you've experienced problems with smear tests that you should definitely seriously consider general anaesthetic.