Hysteroscopy - General or Local Anaesthetic?

[RuzGen]

I had a consultant appointment today for thickened womb lining and a possible cyst or polyp.

Was told I need a hysteroscopy which I'm really quite nervous about.

I'm autistic so possibly more anxious than I should be about it but it's really playing on my mind

I've been offered the option of local or general so wanted to get people's thoughts and experiences.

Currently booked in for general so that they are prepped for either scenario and I can decide later on what to go for (if they booked me for local they wouldn't be prepped for general if I changed my mind on the day)

Consultant said it can cause some "mild discomfort" under local but I've learnt from experience that they tend to under estimate pain.

I'm also quite worried that whatever is going on might have got worse as I've waited a year for this consultant appointment

Any advice or thoughts welcome

Thanks all

It’s bad that you have had to waited a year. Have you had any unusual bleeding?
I had post menopausal bleeding and was seen under the 2WW. I had an ultrasound and because my lining was borderline at 4mm I had the hysteroscopy straight after. I had taken ibuprofen before the appointment as advised and I found the procedure uncomfortable because of the pressure, but not painful. I had cramps for a couple of hours after and a little bleeding. This was 3 weeks ago.
The doctors don’t know who will f8nd it painful and who won’t so it can be tricky.
Fortunately they found nothing wrong and it’s likely caused by the HRT I’m taking, so I was discharged.

Sorry you have had to wait so long but generally if there’s even a small chance of cancer then the NHS can still move quickly ( 2 weeks wait) . Sorry not had a hysteroscopy personally but had 3 IUDs in with no anaesthetic at all but people vary.
If you haven’t had a vaginal delivery much more likely to need a GA .
How are you with other things eg dental work under local?

a few thoughts from an anaesthetist...
what does the surgeon advise? they are usually pretty good at spotting who is likely to find it more uncomfortable (suggested by obstetric history/which way the uterus is pointing/history of discomfort with other gynae examinations etc).

when they say local do they mean local by the surgeon or anaesthetist? the options aren't just GA or local (into the cervix)... it's a procedure that can be done with spinal anaesthetic if you're particularly keen to avoid a GA (so long as there are no contraindications to a spinal).

It also doesn't necessarily have to be an either/or decision... you could start with local by the surgeon and if it goes well that's great, but if it's painful convert to a GA.

why not get a better idea from the surgeon about how straightforward they think the procedure will be and then if they recommend anaesthetic input, talk to the anaesthetist about which option out of spinal/GA would be best for you or how feasible converting on the table would be if you start with local but find it painful. HTH

General

I had a general. I had better things to do than struggle through it and be upset about it. I wanted them to do their job without me messing it up.
The GA was over with very quickly and I wasn't at all groggy afterwards.

I have had it done both ways. Definitely get a general.

General.

I had it done recently with no option of local or general, was just advised to take painkillers beforehand. I have never had any issues with multiple transvaginal scans/ IVF transfers etc so was very underprepared but pain was terrible during it for me. I have a lot of damage, endo/adenomyosis so maybe that contributed to the level of pain. I was given gas and air half way through but I would absolutely insist on local at very minimum if I ever had one again.

I had it done under a spinal and that worked really well as I didn’t need to stay in hospital that long and didn’t need a general but couldn’t feel anything. It wore off after a few hours.

I had one with sedation and it was still awful. Go for the general.

I’ve had 2 hysteroscopies in the last 3 years. I managed both with just gas and air and paracetamol and ibuprofen. It’s painful but if you’ve got a high pain threshold and you’re able to stay calm you’ll be ok. I try and avoid GA unless I really need one as I don’t recover quickly.

I had a general. It was a day procedure, I was only under for about half an hour. I was home by 3pm, no after effects at all. I wasn't willing to risk being one of the people who experiences extreme pain, especially as I find smears painful and haven't had children.

I tried having one with sedation , personally I found it agonising and asked them to stop. Some women are fine with that though. I had it under general - day case and for me that was much better. Good luck with whatever you decide

I had one with 2 anadin extra and it was uncomfortable. There was no scraping or removal. Just an inspection. They wanted me to chat throughout which I found odd/couldnt. Anaesthetic might be better if that’s an option

I opted for a general - I was offered a full range of options but decided I didn’t want to put myself through any pain and it was the best thing ever. I was in and out before I knew it, and back on the ward having a sandwich and a cup of tea. The only thing that I would say is be prepared for a fair amount of bleeding - I didn’t realise it would be like a proper period.

I had one in clinic without and it was fine. The sample they took was nippy, but it had gone by the time I got out of the chair.

I’ve also had it done both ways. Get a general - and l’m very pleased they’re giving you the option - at one stage it got fashionable to do this with none.

I took a couple of painkillers before my hysteroscopy, polyp removal and Mirena coil insertion. I was worried it would be painful but my gynaecologist reckoned because I'd had three vaginal births I'd be OK. He was right, it was mildly uncomfortable and a weird sensation but I didn't find it actually painful at all. I guess I was lucky.

I’ve had it done both ways (local first). I’d never have one again without a general and wish I’d been better informed before the first one as I would have insisted on a general.

General

General all day, every day, and twice on Sundays.

I had a lot of unpleasant IVF and have a high pain threshold but having a womb biopsy was the worst medical procedure I’ve ever had. I personally wouldn’t have one without some type of anaesthetic.

“Deep” sedation should hopefully be an option, I’ve had it at least five times for gynae procedures and it’s relatively easy to recover from compared to a GA.

I haven’t had a vaginal birth and find smears fairly uncomfortable. I found a hysteroscopy with a local where there took biopsies to be really painful & wished I had opted for a GA. I was fine a few hours later so it was short lived but the pain level did shock me.

Wow, they offered you sedation! I was told to take 2 ibuprofen 15 minutes before the procedure and that was it.

I ended up refusing to have it done.

I haven’t read all the replies, but I’ve had 3 of these and a GA each time. I wouldn’t entertain staying awake but that’s me. I know someone who had it done and was fine being awake.
It depends on your pain tolerance, do you find smears painful?.