Hysteroscopy - what to expect?

[ManyAardvarks]

How bad is it and do they discuss options before hand? NHS advice seems to be ibruprofen an hour before and they might offer you gas and air, but beyond NHS advice some people have to have a general anaesthetic? How does that work? Do you get rebooked and have to stay in?

I have thickened uterine lining and some fibroids, but they are only meant to be doing biopsy this week I think, though there was some talk of fibroid removal. I have had two kids (one with epidural, one with nothing), but never had the coil - so trying to gauge what to expect.

I had a colonoscopy years ago and that was uncomfortable, but I was young then. Usually okay with smear test, how different is this?

My hospital automatically book is as a GA procedure, when I've had mine I opted for a spinal instead though which meant I couldn't go home until I'd wee'd.
Have you had any info from your hospital as to how they plan on doing it? Ibuprofen an hour before is frankly barbaric!

How you cope with a hysteroscopy seems to be unpredictable from the threads I've read about it on here.

Some women find it extremely painful and need a GA, which of course they should be able to opt for.

Other women (myself included) find it no worse than a smear test, with just a couple of paracetamol beforehand.

I took the advice of my gynecologist (male) who takes your obstetric history into account. He reckoned after three vaginal deliveries I'd be fine, and in my case that was true; but as I said, I've read on here that even with a similar history to mine some women find it very painful.

It's weird how our bodies react in such different ways, but the bottom line is that we shouldn't have to be in pain - so if you want to have it done under GA, you should request it.

I can't help with how the NHS does things, mine was done on the public health service here in Ireland.

Some people cope OK but my first hysteroscopy was very painful. They couldn’t get a good biopsy sample so I was told I’d have to have another. I requested a GA for the second and it was so easy.

The only info I have is a text saying that it's Gynae Outpatients and then a link to the NHS page: https://www.nhs.uk/tests-and-treatments/hysteroscopy/

So presuming no GA.

Get a GA, don’t suffer the brutality of it. It’s awful they expect women to cope with it

Mine was OK with no anaesthetic (unless there was some local given without my noticing) and I haven't had children. Mine was just to look though, not to actually do anything. I just felt a squeeze at a certain point.

Sounds like you won't get a GA. A GA can be done for outpatients, but you'd be told to have somebody there to go home with you.

I had a hysteroscopy and fibroid removal privately and the doctor was pretty insistent I should have a GA.

It was absolutely fine for me, with just a local anaesthetic in my cervix. Ihad a full myosure procedure and really didn’t feel it at all, however I do have an unusually high pain threshold.

This thread caught my eye as I am in a similar boat - having a hysteroscopy next week due to thinkened uterine lining and fibroids.
I have had this procedure previously and found it unbearable to be honest. The nurses had to hold me down and I nearly threw up whilst they were doing it. This was before I had given birth, so not sure if that contributed to the pain. I have since had a vaginal birth with only gas and air, so I don’t think I am particularly susceptible to pain in general. I’ve never had a problem with smears. I have also had a colonoscopy in the past - what I would say is that the procedure is nothing at all like a hysteroscopy. They are just completely different in terms of what it feels like.
This time I have requested GA and there has been no push back on that, so that’s what’s happening.
I don’t say this to scare you but only because I wish someone had told me that there was a risk the pain would be unbearable before I went in - at the time I naively trotted along with just a paracetamol and afterwards I felt betrayed and traumatised. Since then, I of course have read lots of the stories of other women reporting the same experience. The problem is you have no way of knowing whether you will be in the camp of people who find it ok or the camp who can’t cope - not until you are already there.
If you have the opportunity to request GA, personally I would recommend that. Best of luck whatever you decide.

I found labour contractions to be unbearably painful but I found a hysteroscopy & biopsy to be the same sort of experience as a smear test. I took paracetamol and ibuprofen before and it was fine. Better than a coil insertion. It seems like it is hard to predict beforehand as I read mumsnet threads and went in to the appointment quite nervous based on other people's experiences. Make sure someone else takes you though if possible as I still felt a bit rubbish afterwards and was grateful not to drive home. It was at the hysteroscopy appointment that they asked me what treatment I wanted for the fibroid and told me I would be best to go for a hysterectomy so it was a lot.

I guess though that they will have to rebook if I request a GA? I can't really decide on the day as I won't have fasted.

I don't really want a GA, but I also don't want to be throwing up from pain. It seems everyone is different. I don't know what to think.

I had one last week, it was absolutely fine. It is sometimes described as period level cramps and that was my experience, not a bad period either.
I had no pain relief other than taking paracetamol and ibuprofen an hour earlier, but I did appreciate having a nice nurse at my head end to chat to about shopping to as a distraction.

Apparently about 30% of women experience severe pain.

I don’t think a general rule that it should always be done under GA would be sensible at all given that that would be a lot of unnecessary GAs for the majority of women who don’t need one, but equally, there should be no shame in requesting one if you either know you will have a bad experience or don’t want to take the risk.

They told me they would stop immediately if it was too painful so hopefully that’s true.

I had a Hysteroscopy, and honestly, the recovery was the most painful experience I’ve ever had. I was awake during the procedure, which was uncomfortable, as expected, but manageable. The real trouble started afterwards. I fainted in a supermarket later that day, probably because I ignored the advice to rest and tried to carry on as normal. Big mistake.

In the following days, the pain was unbearable. I didn’t question it at the time, assuming it was normal recovery pain, but looking back, I think my experience was unusual. I struggled to breathe, it felt as though air bubbles were trapped through my chest and torso. Every breath felt like one of them might burst, so I had to take shallow, painful breaths instead.

I’m sharing not to scare you but to suggest asking your doctor in advance about what to expect during recovery. I had to rely heavily on Nurofen Plus just to cope with the pain. It truly was the worst.

I had a GA as mine was private. Hysteroscopy and D&C to strip the uterine lining and private biopsy material.

I was fine until the GA wore off and then I was on the ceiling for three days and needed codeine.

Have the GA.

Agreed. I posted on here at 2am because the paracetemol wasn't going anywhere near the pain. I was sobbing into the pillow in the spare room. Thankfully GP incredibly brilliant and DH was able to collect codeine at 8.45am.

Keep in mind one option is to rock up and see how it goes.
If it’s problematic ally painful then can stop and rebook for a GA. If it’s not, then it’s done and sorted.

GA doesn’t change the recovery pain either way.

Same here. It’s one of the only times in my life I’ve cried from such severe pain. Codeine is a must.

Thank you all, actually feel a bit more prepared with these last replies. Good to know there are options and what people have been through.

I had one a couple of months ago, they gave me a prescription for a tablet to take 3 hours before. Apparently it helps open the cervix and was a painkiller as well. The proceedure itself was uncomfortable, similar to a smear test, and I also had a coil fitted at the same time. No real after effects, bar a little bit of cramping. Drove home and went about the rest of the day as usual.

Not sure anyone would be interested, but had hysteroscopy on Wednesday and it was okay. Pain was like bad period cramps, while it was happening, but very mild afterwards. I had more back/hip pain than anything, as i think holding my pelvis in place while tense wasn't great.
Bleeding stopped within a day.

The options were ibruprofen before or rebook for general anaesthetic. No local offered (in fact explicitly stated no local in consent documents)

I felt faint afterwards and travelling home and exhausted on getting home.

What really helped was asking to watch the whole process on the screen - i was fascinated and distracted, but I get that is not for everyone.

Now to wait for results.