I watched this video the night before my procedure and the comment section completely freaked me out. I got no sleep the night before as a result. I'm literally just back from my polyp removal under local anesthetic in the hospital. I took 2 paracetamol 1.5 hours before and the cervix softening tablets 3 hours before. I had my friend who is a psychotherapist come with me for support. When she got in the car (yes I drove myself there and home), she first helped me to relax by visualising myself with a cute, yellow, baby duck. I imagine petting, stroking and comforting the little ducky and it helps my heart calm down. I also imagine my stomach muscles relax during the procedure along with my baby ducky. I could feel the speculum going in and it was a little uncomfortable, but I kept my visualisation going along with 7/4/11 breath work. I found it important that I don't tense up cos that would make it sore. I felt very little of the local anesthetic being applied. I watched without any pain as the polyp was cut away. The blade is attached to the scope and is like a tiny little coffee grinder with a vaccum attached. So, as the polyp is being cut, the pieces are sucked away. It wasn't until the blades reached close to the uterine lining that I could really feel it. It felt like period cramping and was over in a minute, maybe two. Once completed, the equipment was removed and I rested on the bed while the fluid drained back out. I was a little shaky but it didn't last long and I was up again in a couple minutes and dressed and out the door. The pain kicked in after the local started to wear off while going back to the car. I found the pain increasing and was highly uncomfortable on the drive home. It was also sore to walk from the car to the house and while I was organising myself when I got home. I took some solpadine and the diazapam I was prescribed in advance in case I wanted it to settle my nerves for the procedure. Because I was driving I didn't take it and I'm glad cos the other techniques worked so well. I'm typing this now as the pain is already subsiding while I rest in bed. For anyone who is scared, I'm posting this to let you know that it's really okay. You can ask for relaxers before hand if you think you will be panicking or anything like that. You can also ask for prescription pain relief. Really and truly, the local is a great way to go to get this done. There's allot of misinformation out there and everyone is different. The nurses and Dr I had all told me I was absolutely brilliant, cos a lot of women go in with massive fear and nerves which doesn't help them at all and makes them more sensitive to the procedure. This may be TMI, but I pooped when I got home and there was some blood in it and that's normal. I hope this information helps some one because I wish I had this when I was going in. All the best! ❤
It may have been asked many times but i need to ask this question. During the outpatient appointment, why can't you numb slightly the entrance to the uterus in order for the pain to be less invasive? Im sure this would make women feel comfortable and doctors don't feel anxious on which patient going to scream out. Surely this would make sense, you would certainly get lots and lots of women going forward to have it done. Carol UK
@cpet5048 Hi, it's definitely an option. The trouble is that most of the pain from hysteroscopy is due to the fluid stretching the womb, not going through the cervix, unless the cervix is closed. A cervical block involves injecting local anaesthetic into several places in the cervix with a needle. This itself can be quite painful for some women, and potentially more painful that the scope passing through the cervix. If the cervix, on the other hand, needs to be dilated, a cervical block is often a good idea.
Had this done under general anesthetic this week plus polyp removal. Still got quite bad cramping pain two days on but very pleased with my decision to have a GA - - if you are worried about this proceedure ask for pain relief or anesthesia - don't suffer in silence. Personally found the transvaginal ultrasound very painful proceeding this which is why I went for a GA. Good luck everyone being female has its moments, so best to share our common experiences to help each other.
I had a hysteroscopy with D&C last year after I refused to have an endometrial biopsy in the office because of pain. I cannot comprehend that you are doing these procedures without sedation. This is absolutely and utterly barbaric. I was put to sleep using propofol, given appropriate pain management and after the procedure experienced absolutely zero pain, which is as it should be. The fact that the medical profession continues to perform procedures such as IUD insertion, office D&C, endometrial biopsy, cervical biopsy and hysteroscopy without sedation is unconscionable. Women of the world, if your healthcare provider is not offering you appropriate sedation and pain management, find another doctor. I live in the US.
I might add that I ultimately ended up with a radical hysterectomy which means they took everything including my cervix and did lymph node biopsies. (Everything came back negative.) I had a fabulous surgeon, he did a robot assisted procedure. I was home before 1 p.m. the same day, I had minimal discomfort, I was driving within a couple of days and doing all my normal activities of daily living except picking up anything heavier than 15 lb. I required no pain medication after the surgery, I only took Tylenol for a couple of days. My point is, there are doctors who manage women's needs appropriately. I would also point out I was provided very adequate pain management in the PACU and given appropriate oral medications to take home.
Here in the U.K you are no longer offered a general anaesthetic. When you say in the office I assume this is your private doctors clinic? Here in the UK this would be done in a hospital in a proper medical setting with a multitude of clinicians. I had one done two years ago it wasn’t pleasant but it wasn’t excruciating pain. I feel like in the US everything is over medicalised . Of course there are instances where extra pain relief is needed, but if you’ve given birth vaginally it’s nothing compared to that. .
I had this done in 2020 with no sedation (was given two Advil) and it included insertion of an IUD, biopsy and polyp removal. Yesterday I had a hysteroscopy done under sedation with biopsy, polyp removal and IUD removal. I agree that WITHOUT sedation a hysteroscopy is barbaric!! Do not do it. Under sedation I had little to no pain or cramping and the leaking/bleeding has nearly stopped already. Please find a different, compassionate doctor who will treat you humanely.
The big thing that's missing is a conversation before hand of a plan of action if it is too painful. Mine was so painful the consultant thought it should be stopped and gave me that option but when in pain you cannot think clearly, and all I could think of is, that I couldn't go through it again so she had to continue. I was offered the choice of a general anesthetic 4 weeks prior when the appointment was made, but in the midst of excruciating pain couldn't think of any other option but to continue. If the route of action had been discussed before the start I could have said stop. The pain was so severe that for an hour after they couldn't sit me as each time my blood pressure dropped and I struggled to talk. Doctors need to explain what "severe pain" actually means. If you're the 1 in 3 it is torture.
@@janemarshall16 my God, this sounds like backstreet abortion in the Victorian days. I've seen articles about this, honestly is this the best medical scientist come up with?! Knitting needles
Thank you, this is an excellent video, probably the most honest and compassionate I’ve ever seen on hysteroscopy. Most of the videos on here are dreadful, telling women it’s painless (!!!), mildly uncomfortable and other such lies. This video is straightforward and reassuring. If only all gynaes did their jobs like this - but sadly most seem to adopt the “it’s only a woman, she’ll have to put up with it” attitude. So ladies, stand up for your rights - no-one is entitled to cause you pain like this. Advocate for yourself and refuse to be treated like your feelings don’t matter
I’d also like to add that showing the instruments used was very helpful and whilst they are long, they are also narrow - tho I assume you showed a vaginoscope? which should be used, but seldom is unfortunately. The more honest, open information like this that women are given, the truer their consent will be and the less frightened they will be. It may put some off going thru with the procedure, but that’s not a reason to withhold information, that’s a reason to improve pain control. There is little that is more frightening than unexpected pain - you assume that something has gone wrong - at least if you know it might be painful, you can decide for yourself whether it’s right for you or not
I am a post menopausal woman with bleeding. I was told by my gynaecologist I had a lesion within my womb. A whole month went by while I waited for my hysteroscopy. It was the longest month of my life - convinced I had cancer. I eventually had the hysteroscopy (under general anaesthetic) and the surgeon said there was absolutely nothing in my womb! Very confusing to me as they saw a lesion on the ultrasound scan. It turns out that sometimes ultrasound scans can produce false negatives and the bleeding was due to being on sequential HRT. I am writing this to reassure other women going through the same thing.
I’ve had 3 as an outpatient….wasnt even given the option of general anaesthetic…..the third one was done by a locum doctor who never gave me any pain relief at all. It was horrendous and I was very upset. My local hospital as now offered me general anaesthetic for my 4th one which is better for me…this was in Telford, Uk
You're clearly a caring and highly experienced hysteroscopist at the top of your profession. Sadly most patients won't be seeing you. Yes - 1 in 3 patients will be absolutely fine. But 1 in 3 currently suffer SEVERE pain and distress during outpatient hysteroscopy. That's shocking. It would be considered an unacceptable pain rate in dentistry - so why does gynaecology have lower surgical standards? Please why isn't your hospital offering the option of IV sedation+analgesia? It's routinely offered for colonoscopy and other endoscopies. North West Anglia Trust, Furness General, Swansea and Cardiff offer IV conscious sedation for hysteroscopy. The Campaign Against Painful Hysteroscopy has heard from thousands of women who've been traumatised by awake womb endoscopy. Tragically, some of these women delay returning for further gynae investigations and treatment. It's time to guarantee ALL women pain-free hysteroscopy. Why was anaesthesia invented?
@@kathyfullarton8126I think you're confusing published statistics from the medical literature with my personal figures. It is right to quote published figures to give women an accurate idea of risks. It would be unethical not to warn women of risks. Thanks for watching the video anyway. I'm happy to offer all women choice.
@kathyfullarton8126 These are published statistics. I can confirm that I have never needed to proceed to laparoscopy (keyhole surgery) or laparotomy (big cut on tummy) at hysteroscopy. I've never needed to take a patient having an outpatient hysteroscopy to theatre.
@@kathyfullarton8126 Agree wholeheartedly. Having experienced two painful procedures I can confirm what you have said in your post. I had the first in 2015 (pre menopause) & the second last year (post menopause). The first was extremely painful until i was informed I could have a LA. Why was this not mentioned before? Anyway, after the LA, it was ok. The second, even though I insisted on a LA (I was made to feel i was making a fuss), was torture. I was sweating, near to fainting & couldn't speak.The doctor stopped the procedure & I am now booked in for a GA.I feel ignored, gaslit (2 analgesics pre op - you're having a laugh). And BTW I can put up with 'period pains' I cannot put up with my stenotic cervix being forced open with a barbaric instrument of torture.
My procedure was very painful. My procedure was called a biopsy! I thought that having an IUD placed was painful, but this was 10 times more painful. She talks about options, and I wasn't given any at any point. I suppose it all depends on your medical team and their methods.
While I don’t know anything about medicine and I don’t have any right to say whether a patient or doctor can know beforehand, how much pain a patient will end up in, I’m gonna take a gander that, with outpatient procedures, it sounds as if they know things might become painfully out of control, by sometimes offering increasing amounts of pain management, in order to complete the procedure, with the likelihood of them already knowing, you’re not likely to “feel a bit of pressure” or “feel a pinch”, as is commonly stated by doctors, probably so you just don’t know what’s coming, until it’s too late to do anything about it. Im not saying this to paint doctors as bad, unempathetic people. I just think many of us, man or woman, have been subjected to the pressure/pinch fib. This can also be a risk, for hospital staff., perhaps. My stepfather went through a procedure and he ended up hurling the doctor across the room. Someone I know, who is trying to get pregnant said that women’s healthcare is barbaric and way behind times. And, although the place I went to, to get my ultrasound done is not the place that performs hysteroscopies, they, nor their system, could even figure out that I could NOT POSSIBLY prepare for transvaginal and abdominal ultrasounds, on the same visit. I think I’ll just have to look at my insurance and see if I can go to the hospital, rather than to have myself e absolutely terrified, of what might be a possibly sadistic procedure, in terms of being numb to how much pain I might get into.
Recently had one. They were going to use a general but I said I’d prefer conscious sedation converting to general, if needed. Went great without converting to general and never felt a thing until conscious. Uncomfortable but pain controlled with just Tylenol. Couldn’t imagine without any anesthesia!
Yes in the office would be in the doctor's private clinic. In a clinic setting, no sedation is offered and no pain medication is given. In a hospital setting, you may receive conscious sedation with a cocktail including propofol. You may also receive pain medication. Not everyone has the same degree of tolerance for these procedures and therein lies the need for giving patients the option of sedation. When I was in my twenties I had a cervical biopsy in the office with no anesthesia and no pain medication. While for me it was painless, for many patients it is excruciatingly painful.
I had one under anesthesia because iv had a biopsy on my cervix in my younger years and that was the most traumatic experience of my life. I think it was best for the safety of myself and care team involved.
I had a hysteroscopy, but I went in the operating room, and the procedurewas done. I wish I could of seen it on camera while they did it. I had abnormal bleeding, but I didn't feel anything, and recovered. Everything turned out normal, they removed fibroids, and polyps so, the doctor removed tissue. I had to go to the hospital. That medication when I woke up made me so sick. I had no pain afterwards, I was fine.
I’m booked in for an outpatient hysteroscopy , biopsy and merina coil fitting due to heavy periods and several internal uterine fibroids (I also have a large one outside the uterus). I appreciate this video. I’m quite sure that a couple of paracetamol is not going to do the trick. The procedure sounds horrible, but I would feel like I was making a fuss to insist on a GA.
@@lawsbrettart It doesn't have to be a general anesthesia, it can be conscious sedation, similar to what you would get with a colonoscopy. Do not under any circumstances feel you are obligated to undergo painful procedures without appropriate sedation and pain management. When they tell you you might feel a sting or cramping, the underexaggeration is ridiculous.
I had one under GA as I was too scared without. I woke up to be told that they were not able to do the procedure and do not understand why. I am now really worried and an awaiting a subsequent ultrasound result, but feel that I am back at square one and worried as do not know what is causing my pain. If they can’t do a Hysteroscopy what next?
No just said they couldn’t do it as worried about perforation. I vaguely remember them saying this as I was just waking from anaesthetic and still groggy so did not question. Asked in Recovery later and they couldn’t help 😢 …neither could my GP who had never heard of it before. Thanks for replying x
@suefletcher1186 ok, it sounds as if your cervix may be stenosed (tightly closed). That in itself shouldn't worry you. I guess the rescan is to come up with a new plan. Sometimes, hysteroscopy can be achieved using cervical preparation first (e.g. misoprostol) to soften the cervix, sometimes ultrasound scanning at the same time helps (but not always - can still be difficult or impossible). I'm sure they are considering how to progress your care.
I was originally sent on the cancer pathway due to wall thickening, polyp and fibroids so was worried about them leaving it due to not being able to do the hysteroscopy. Thanks for replying and advising of possible further options, much appreciated x
Tried this today, it was as painful as my pancreatitis pain was, we had to stop and make a new apppointment with general anaesthetic. Very painful. Take pads with you.
Hi Dr Gail! I'm about to have my hysteroscopy due to heavy menstrual bleeding and fibroids. My fear is that I've had 2 Caesarean sections prior. Will hysteroscopy still be a safe procedure? Hoping to hear from you! Thank you so much!
Have a plan if you're one of the 1 in 3. Just because it might be safe doesn't mean it won't be painful. If you are a 1 in 3, they'll ask if you want to stop but often don't tell you what the options are if you do stop. When you're in pain is not the time to be asking questions that you need answering to make that choice!
Hi. Well it depends. If as an outpatient, you leave either immediately after or maybe go to a recovery area for a bit. Most people are OK to just carry on with their normal activities that day or the day after. If under anaesthetic, you will be in hospital for a few hours after. You can't drive for 24 hours after a general anaesthetic and need someone to be with you at home that night, just in case. Again you should be OK after a day or two. Of course these time scales can vary a bit depending on the procedure and the individual patient, but the vast majority will be ok after a few days.
How long do i wait for my biopsy from this? I had myosure. It was awful. So they expected to find a polyp and it had been noted i have a bulky womb. What they thought was a polyp was removed for and sent for biopsy as it wasnt a polyp and my fundus was shaved down flat. I did not tolerate it well but i just grinned and bared it because i needed it over with. I would NOT recommend this but i am a redhead and it took till after thr procedure for the local to work. The last 48 hours since i have been vadky bloated, my kidneys ache. The cramping has died down some but i have intermittent bleeding like a tap having been turned on when walked around or sitting up. I have no idea if this is normal. I was squeezed in to someone elses appointment having not known i needed this so i didn't getthe usual sheet of information others get. Could someone advise me if this is normal? There doesnt seem to be any infection signs
@sillycookie1982 Hi, the length of time to the biopsy result varies. There is a faster route if the findings look suspicious. If not, then maybe a few weeks. Depends on the hospital. Regarding your bleeding, this can occur for a week or two, and should gradually get lighter. However if things are getting worse, rather than better (pain, bloating, vomiting), it is probably best to be checked over at the hospital or your GP.
I had one yesterday with Kaiser and it was a wonderful experience!! Very easy , the nurses were so kind and helpful , I bled just a tiny bit after , no cramping . The procedure did hurt but not to bad . Over all it was good
@ThatsSSoooNiya hi. They are completely different investigations. A colposcopy looks at the cervix from outside, whereas in a hysteroscopy the telescope goes higher up, through your cervix into your womb.
Whether a woman ends up with an empathetic consultant like you (or not) and whether they’re one of the many women who experience excruciating pain (or not) is unfortunately something they won’t discover until the day of their outpatients appointment. I know many women who have been left traumatised and, in some cases, butchered, but it saves the NHS money to tell them to take Paracetamol beforehand (rather than having it under a general anaesthetic - as I understand used to be the norm) so that’s ok
I am scheduled to have an outpatient hysterosopy and I am terrified. As a teacher, one of my subjects is history, including the module on the history of medicine. Why do I feel that women are being expected to travel back in time to an era of pain and fear.?
@user-gk2nl6nz6z Hi. Home the same day with GA, as outpatient pain settles quickly to mild cramps in most cases. Walk out of clinic at end of appointment. Regarding intimacy, until the watery loss settles. About 2 weeks.
Hi. Thank you for thorough explanation. Is it common to have this procedure for a thick endometrial lining? Mine was a 14. I stopped getting periods 1.5 year ago & have occasional 'light spotting', & also mucus. Is it possible come day of procedure my lining won't be as thick, & will the dr see that through camera, where she possibly then WONT have to scrape out my whole lining as she said her plan is? She is doing biopsies.
Hi. Yes it is common to have it for a thick womb lining, especially in postmenopusal women. It would be usual to take a biopsy, which is a small sample, not the whole womb lining. A thickened womb lining may also mean the presence of a polyp - which your doctor will be able to see. Hope this helps and good luck with it!
@drgailbusby thank you for responding so quickly. Yes your answer helped. She did mention scraping my whole lining. Should I be concerned about that & ask more questions?
Hi Dr.i have an endometrium thickness of 15.it has increased from 8 in the last 7 months.i did a hysteroscopy.i did have polyps and a fibroid.The doctor said she has removed the fibroid and 3 polyps but was not able to remove everything.i have no symptoms at all.i came upon the above during a routine master check up.my doctor is advising removal of uterus.i am very concerned snout removal of uterus as I am afraid it can cause hernia and other consequences.Please advise your opinion.hysteroscopy results came out as non malignant.
Thnx dr I had today this test I m trying 2 nd baby , I reduced my weight now , dr checking me today and no forbids no any adsiue clear my womb they are v happy from uk
I’m glad I watched this video, I have made my decision that I will not be having this procedure done. I’ll get some menopause eventually and I already know how to deal with the issues I have so I’m just going to wait it out.
@TM-vg4mx Hi, ideally it should not be done during a period as the blood within the womb will obscure the view. It can often be done if bleeding is quite light - the very start or very end of a period. Thanks.
Hi, I recently had a transvaginal scan. It was a horrendous experience and I am going in for a hysteroscopy tomorrow. I have no polyps or fibroids, so I know they are taking a biopsy due to a finding of an irregular edge and thickened area of my womb. I have had 2 knee replacements and a hip replacement and I just could not get into the correct position and felt berrated because of this., I was lying on a normal bed with NO stirrups, this information would have been in my notes. I have recently just finished a 6 year course of hormonal adjuvant therapy for breast cancer Stage II invasive ductal carcinoma. I felt unheard, due to the constant questioning of my breast cancer and how long I had been on a certain medication. All this information is in my notes this should have been read prior to my appointment,. Having my masectomy was less painful. I got very emotional, as REMISSION is a very safe. and powerful word. I am now scared for tomorrow and also scarred emotionally from the whole procedure. I am dreading tomorrow as my appointment is not until late afternoon. I look forward to writing my friends and family review about both procedures after comparing the 2!! Thank you for your informative video, which is very thorough and knowing now I have a choice to stop if it is too painful is very comforting and I will do just that. I wish I was seeing you! Any words of wisdom? I will update you on how I get on. With many thanks.
@louiseharfleet7346 Thank you for your lovely feedback. Please don't be scared. You should be the boss in that room. It is your body and your choice. If you opt to have an outpatient hysteroscopy, take painkillers about an hour before (Paracetamol and Ibuprofen if safe for you). Have a light meal before as well. Ask what pain relief is available (heat pack, gas and air if needed). Most of all, be prepared to advocate for yourself. It may be absolutely fine for you, it is in most cases, but if not, ask for a theatre procedure. Best of luck, you've got this!
Colposcopy is looking at the cervix, whereas hysteroscopy involves passing a thin telescope through the cervix to look inside the womb. In colposcopy, a speculum is used like a smear test and the cervix is looked at through an instrument which is outside the speculum. Biopsies can be taken from the cervix at colposcopy by taking tiny bites of the cervix. Sometimes, a bigger piece of cervix is taken at colposcopy using a loop of wire.
@@drgailbusby ok thanks for explaining . I had both of these done along with a d&c to remove a polyp. I also had thickened endometrial lining. She took the sample & I had the d&c a few days later.
Im Post menopausal and went for a general anesthesia hysteroscopy today for removal/biopsy of polyps. The doctor could not get through my cervix. He wrote: Indication for Surgery: Postmenopausal bleeding, scan found endometrial thickness and a uterine polyp Procedure: Position: Lithotomy Anaesthesia: General Anaesthesia Findings Normal looking vagina and vlulva full inspection of the vagina and vulva done with the vaginoscope good view achieved. No defined cervix noted however the firm area in the anterior area found . gently tried to insert the camera through a supposedly cervical os but very stenosed and not able to enter used half size dilators small cx os to try to dilate but not possible to dilate - almost a frozen wall instead of a pinhole multiple attempts made. Ultrasound scan guided dilatation attempted but not successful. It is very likely that this is not only stemnosed cervix but completely closer cervix and will need an excision of cervix to be able to enter the uterine cavity or to consider alternative means to check for endometrial health and removal of polyp . Normal looking cervix What do you recommend? I did not like that he wrote it was almost a frozen wall instead of a pinhole.
I’m glad I watched this video, I have made my decision that I will not be having this procedure done. I’ll get some menopause eventually and I already know how to deal with the issues I have so I’m just going to wait it out.
I watched this video the night before my procedure and the comment section completely freaked me out. I got no sleep the night before as a result.
I'm literally just back from my polyp removal under local anesthetic in the hospital. I took 2 paracetamol 1.5 hours before and the cervix softening tablets 3 hours before. I had my friend who is a psychotherapist come with me for support. When she got in the car (yes I drove myself there and home), she first helped me to relax by visualising myself with a cute, yellow, baby duck. I imagine petting, stroking and comforting the little ducky and it helps my heart calm down. I also imagine my stomach muscles relax during the procedure along with my baby ducky.
I could feel the speculum going in and it was a little uncomfortable, but I kept my visualisation going along with 7/4/11 breath work. I found it important that I don't tense up cos that would make it sore.
I felt very little of the local anesthetic being applied. I watched without any pain as the polyp was cut away.
The blade is attached to the scope and is like a tiny little coffee grinder with a vaccum attached. So, as the polyp is being cut, the pieces are sucked away. It wasn't until the blades reached close to the uterine lining that I could really feel it. It felt like period cramping and was over in a minute, maybe two. Once completed, the equipment was removed and I rested on the bed while the fluid drained back out. I was a little shaky but it didn't last long and I was up again in a couple minutes and dressed and out the door.
The pain kicked in after the local started to wear off while going back to the car. I found the pain increasing and was highly uncomfortable on the drive home. It was also sore to walk from the car to the house and while I was organising myself when I got home.
I took some solpadine and the diazapam I was prescribed in advance in case I wanted it to settle my nerves for the procedure. Because I was driving I didn't take it and I'm glad cos the other techniques worked so well. I'm typing this now as the pain is already subsiding while I rest in bed.
For anyone who is scared, I'm posting this to let you know that it's really okay. You can ask for relaxers before hand if you think you will be panicking or anything like that. You can also ask for prescription pain relief.
Really and truly, the local is a great way to go to get this done. There's allot of misinformation out there and everyone is different. The nurses and Dr I had all told me I was absolutely brilliant, cos a lot of women go in with massive fear and nerves which doesn't help them at all and makes them more sensitive to the procedure.
This may be TMI, but I pooped when I got home and there was some blood in it and that's normal.
I hope this information helps some one because I wish I had this when I was going in.
All the best! ❤
Thanks for sharing your experience.
You r wonderful! We need more positive people out there with the true answers. Thank you for sharing, carol from UK 😊
It may have been asked many times but i need to ask this question. During the outpatient appointment, why can't you numb slightly the entrance to the uterus in order for the pain to be less invasive? Im sure this would make women feel comfortable and doctors don't feel anxious on which patient going to scream out. Surely this would make sense, you would certainly get lots and lots of women going forward to have it done. Carol UK
@cpet5048 Hi, it's definitely an option. The trouble is that most of the pain from hysteroscopy is due to the fluid stretching the womb, not going through the cervix, unless the cervix is closed. A cervical block involves injecting local anaesthetic into several places in the cervix with a needle. This itself can be quite painful for some women, and potentially more painful that the scope passing through the cervix.
If the cervix, on the other hand, needs to be dilated, a cervical block is often a good idea.
@@drgailbusbythank you for your reply, much appreciated!
Had this done under general anesthetic this week plus polyp removal. Still got quite bad cramping pain two days on but very pleased with my decision to have a GA - - if you are worried about this proceedure ask for pain relief or anesthesia - don't suffer in silence. Personally found the transvaginal ultrasound very painful proceeding this which is why I went for a GA. Good luck everyone being female has its moments, so best to share our common experiences to help each other.
I had a hysteroscopy with D&C last year after I refused to have an endometrial biopsy in the office because of pain. I cannot comprehend that you are doing these procedures without sedation. This is absolutely and utterly barbaric. I was put to sleep using propofol, given appropriate pain management and after the procedure experienced absolutely zero pain, which is as it should be. The fact that the medical profession continues to perform procedures such as IUD insertion, office D&C, endometrial biopsy, cervical biopsy and hysteroscopy without sedation is unconscionable. Women of the world, if your healthcare provider is not offering you appropriate sedation and pain management, find another doctor. I live in the US.
I agree! I had a hysteroscopy last week with anesthesia. No way would I have it in done in an office!
I might add that I ultimately ended up with a radical hysterectomy which means they took everything including my cervix and did lymph node biopsies. (Everything came back negative.) I had a fabulous surgeon, he did a robot assisted procedure. I was home before 1 p.m. the same day, I had minimal discomfort, I was driving within a couple of days and doing all my normal activities of daily living except picking up anything heavier than 15 lb. I required no pain medication after the surgery, I only took Tylenol for a couple of days. My point is, there are doctors who manage women's needs appropriately. I would also point out I was provided very adequate pain management in the PACU and given appropriate oral medications to take home.
I had it with a local to the cervix. I described it as Victorian torture
Here in the U.K you are no longer offered a general anaesthetic. When you say in the office I assume this is your private doctors clinic? Here in the UK this would be done in a hospital in a proper medical setting with a multitude of clinicians. I had one done two years ago it wasn’t pleasant but it wasn’t excruciating pain. I feel like in the US everything is over medicalised . Of course there are instances where extra pain relief is needed, but if you’ve given birth vaginally it’s nothing compared to that.
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I had this done in 2020 with no sedation (was given two Advil) and it included insertion of an IUD, biopsy and polyp removal. Yesterday I had a hysteroscopy done under sedation with biopsy, polyp removal and IUD removal. I agree that WITHOUT sedation a hysteroscopy is barbaric!! Do not do it. Under sedation I had little to no pain or cramping and the leaking/bleeding has nearly stopped already. Please find a different, compassionate doctor who will treat you humanely.
The big thing that's missing is a conversation before hand of a plan of action if it is too painful. Mine was so painful the consultant thought it should be stopped and gave me that option but when in pain you cannot think clearly, and all I could think of is, that I couldn't go through it again so she had to continue. I was offered the choice of a general anesthetic 4 weeks prior when the appointment was made, but in the midst of excruciating pain couldn't think of any other option but to continue. If the route of action had been discussed before the start I could have said stop.
The pain was so severe that for an hour after they couldn't sit me as each time my blood pressure dropped and I struggled to talk.
Doctors need to explain what "severe pain" actually means. If you're the 1 in 3 it is torture.
@@janemarshall16 my God, this sounds like backstreet abortion in the Victorian days. I've seen articles about this, honestly is this the best medical scientist come up with?! Knitting needles
Thank you, this is an excellent video, probably the most honest and compassionate I’ve ever seen on hysteroscopy. Most of the videos on here are dreadful, telling women it’s painless (!!!), mildly uncomfortable and other such lies. This video is straightforward and reassuring. If only all gynaes did their jobs like this - but sadly most seem to adopt the “it’s only a woman, she’ll have to put up with it” attitude.
So ladies, stand up for your rights - no-one is entitled to cause you pain like this. Advocate for yourself and refuse to be treated like your feelings don’t matter
@ValerieHumphreys thank you for your feedback, it's very much appreciated.
I’d also like to add that showing the instruments used was very helpful and whilst they are long, they are also narrow - tho I assume you showed a vaginoscope? which should be used, but seldom is unfortunately.
The more honest, open information like this that women are given, the truer their consent will be and the less frightened they will be. It may put some off going thru with the procedure, but that’s not a reason to withhold information, that’s a reason to improve pain control. There is little that is more frightening than unexpected pain - you assume that something has gone wrong - at least if you know it might be painful, you can decide for yourself whether it’s right for you or not
I am a post menopausal woman with bleeding. I was told by my gynaecologist I had a lesion within my womb. A whole month went by while I waited for my hysteroscopy. It was the longest month of my life - convinced I had cancer. I eventually had the hysteroscopy (under general anaesthetic) and the surgeon said there was absolutely nothing in my womb! Very confusing to me as they saw a lesion on the ultrasound scan. It turns out that sometimes ultrasound scans can produce false negatives and the bleeding was due to being on sequential HRT. I am writing this to reassure other women going through the same thing.
Thanks for posting as I've got hysteroscopy in 10 days time and dreading it, you've certainly helped ease a few worries
Make sure you are taking enough progesterone.
I’ve had 3 as an outpatient….wasnt even given the option of general anaesthetic…..the third one was done by a locum doctor who never gave me any pain relief at all. It was horrendous and I was very upset. My local hospital as now offered me general anaesthetic for my 4th one which is better for me…this was in Telford, Uk
You're clearly a caring and highly experienced hysteroscopist at the top of your profession. Sadly most patients won't be seeing you. Yes - 1 in 3 patients will be absolutely fine. But 1 in 3 currently suffer SEVERE pain and distress during outpatient hysteroscopy. That's shocking. It would be considered an unacceptable pain rate in dentistry - so why does gynaecology have lower surgical standards? Please why isn't your hospital offering the option of IV sedation+analgesia? It's routinely offered for colonoscopy and other endoscopies. North West Anglia Trust, Furness General, Swansea and Cardiff offer IV conscious sedation for hysteroscopy. The Campaign Against Painful Hysteroscopy has heard from thousands of women who've been traumatised by awake womb endoscopy. Tragically, some of these women delay returning for further gynae investigations and treatment. It's time to guarantee ALL women pain-free hysteroscopy. Why was anaesthesia invented?
Still working on this...
@@kathyfullarton8126I think you're confusing published statistics from the medical literature with my personal figures. It is right to quote published figures to give women an accurate idea of risks. It would be unethical not to warn women of risks.
Thanks for watching the video anyway.
I'm happy to offer all women choice.
@kathyfullarton8126 These are published statistics. I can confirm that I have never needed to proceed to laparoscopy (keyhole surgery) or laparotomy (big cut on tummy) at hysteroscopy. I've never needed to take a patient having an outpatient hysteroscopy to theatre.
@@kathyfullarton8126
Agree wholeheartedly. Having experienced two painful procedures I can confirm what you have said in your post. I had the first in 2015 (pre menopause) & the second last year (post menopause). The first was extremely painful until i was informed I could have a LA. Why was this not mentioned before? Anyway, after the LA, it was ok. The second, even though I insisted on a LA (I was made to feel i was making a fuss), was torture. I was sweating, near to fainting & couldn't speak.The doctor stopped the procedure & I am now booked in for a GA.I feel ignored, gaslit (2 analgesics pre op - you're having a laugh). And BTW I can put up with 'period pains' I cannot put up with my stenotic cervix being forced open with a barbaric instrument of torture.
My procedure was very painful. My procedure was called a biopsy! I thought that having an IUD placed was painful, but this was 10 times more painful. She talks about options, and I wasn't given any at any point. I suppose it all depends on your medical team and their methods.
While I don’t know anything about medicine and I don’t have any right to say whether a patient or doctor can know beforehand, how much pain a patient will end up in, I’m gonna take a gander that, with outpatient procedures, it sounds as if they know things might become painfully out of control, by sometimes offering increasing amounts of pain management, in order to complete the procedure, with the likelihood of them already knowing, you’re not likely to “feel a bit of pressure” or “feel a pinch”, as is commonly stated by doctors, probably so you just don’t know what’s coming, until it’s too late to do anything about it. Im not saying this to paint doctors as bad, unempathetic people. I just think many of us, man or woman, have been subjected to the pressure/pinch fib. This can also be a risk, for hospital staff., perhaps. My stepfather went through a procedure and he ended up hurling the doctor across the room. Someone I know, who is trying to get pregnant said that women’s healthcare is barbaric and way behind times. And, although the place I went to, to get my ultrasound done is not the place that performs hysteroscopies, they, nor their system, could even figure out that I could NOT POSSIBLY prepare for transvaginal and abdominal ultrasounds, on the same visit.
I think I’ll just have to look at my insurance and see if I can go to the hospital, rather than to have myself e absolutely terrified, of what might be a possibly sadistic procedure, in terms of being numb to how much pain I might get into.
Recently had one. They were going to use a general but I said I’d prefer conscious sedation converting to general, if needed. Went great without converting to general and never felt a thing until conscious. Uncomfortable but pain controlled with just Tylenol. Couldn’t imagine without any anesthesia!
Yes in the office would be in the doctor's private clinic. In a clinic setting, no sedation is offered and no pain medication is given. In a hospital setting, you may receive conscious sedation with a cocktail including propofol. You may also receive pain medication. Not everyone has the same degree of tolerance for these procedures and therein lies the need for giving patients the option of sedation.
When I was in my twenties I had a cervical biopsy in the office with no anesthesia and no pain medication. While for me it was painless, for many patients it is excruciatingly painful.
I had one under anesthesia because iv had a biopsy on my cervix in my younger years and that was the most traumatic experience of my life. I think it was best for the safety of myself and care team involved.
@@user-yi1nf4cc1x that's fair enough! Absolutely a personal choice.
I had a hysteroscopy, but I went in the operating room, and the procedurewas done. I wish I could of seen it on camera while they did it. I had abnormal bleeding, but I didn't feel anything, and recovered. Everything turned out normal, they removed fibroids, and polyps so, the doctor removed tissue. I had to go to the hospital. That medication when I woke up made me so sick. I had no pain afterwards, I was fine.
I’m booked in for an outpatient hysteroscopy , biopsy and merina coil fitting due to heavy periods and several internal uterine fibroids (I also have a large one outside the uterus). I appreciate this video. I’m quite sure that a couple of paracetamol is not going to do the trick. The procedure sounds horrible, but I would feel like I was making a fuss to insist on a GA.
@@lawsbrettart It doesn't have to be a general anesthesia, it can be conscious sedation, similar to what you would get with a colonoscopy. Do not under any circumstances feel you are obligated to undergo painful procedures without appropriate sedation and pain management. When they tell you you might feel a sting or cramping, the underexaggeration is ridiculous.
I had one under GA as I was too scared without. I woke up to be told that they were not able to do the procedure and do not understand why. I am now really worried and an awaiting a subsequent ultrasound result, but feel that I am back at square one and worried as do not know what is causing my pain. If they can’t do a Hysteroscopy what next?
@@suefletcher1186 did they not explain why?
No just said they couldn’t do it as worried about perforation. I vaguely remember them saying this as I was just waking from anaesthetic and still groggy so did not question. Asked in Recovery later and they couldn’t help 😢 …neither could my GP who had never heard of it before. Thanks for replying x
@suefletcher1186 ok, it sounds as if your cervix may be stenosed (tightly closed). That in itself shouldn't worry you. I guess the rescan is to come up with a new plan. Sometimes, hysteroscopy can be achieved using cervical preparation first (e.g. misoprostol) to soften the cervix, sometimes ultrasound scanning at the same time helps (but not always - can still be difficult or impossible). I'm sure they are considering how to progress your care.
I was originally sent on the cancer pathway due to wall thickening, polyp and fibroids so was worried about them leaving it due to not being able to do the hysteroscopy. Thanks for replying and advising of possible further options, much appreciated x
@@suefletcher1186 you're welcome. Good luck.
Tried this today, it was as painful as my pancreatitis pain was, we had to stop and make a new apppointment with general anaesthetic. Very painful. Take pads with you.
I'm having one this Friday. It will be under general anesthesia.
Wishing you the best ❤
Hi Dr Gail! I'm about to have my hysteroscopy due to heavy menstrual bleeding and fibroids. My fear is that I've had 2 Caesarean sections prior. Will hysteroscopy still be a safe procedure? Hoping to hear from you! Thank you so much!
@thecalling1981 Hi. Yes hysteroscopy is safe if you have had Caesarean sections.
@@drgailbusby thanks Dr Gail!! much appreciated!
Have a plan if you're one of the 1 in 3. Just because it might be safe doesn't mean it won't be painful. If you are a 1 in 3, they'll ask if you want to stop but often don't tell you what the options are if you do stop. When you're in pain is not the time to be asking questions that you need answering to make that choice!
How did everything go ?
@@leilanoorbellydance things went well, thank God!! now on my 5th week after the procedure
Hi dr gail next week i will have these procedures with biopsy because of heavy bleedings. May i ask how long the recovery after the procedure?
Hi. Well it depends. If as an outpatient, you leave either immediately after or maybe go to a recovery area for a bit. Most people are OK to just carry on with their normal activities that day or the day after. If under anaesthetic, you will be in hospital for a few hours after. You can't drive for 24 hours after a general anaesthetic and need someone to be with you at home that night, just in case. Again you should be OK after a day or two.
Of course these time scales can vary a bit depending on the procedure and the individual patient, but the vast majority will be ok after a few days.
How long do i wait for my biopsy from this? I had myosure. It was awful. So they expected to find a polyp and it had been noted i have a bulky womb. What they thought was a polyp was removed for and sent for biopsy as it wasnt a polyp and my fundus was shaved down flat. I did not tolerate it well but i just grinned and bared it because i needed it over with. I would NOT recommend this but i am a redhead and it took till after thr procedure for the local to work. The last 48 hours since i have been vadky bloated, my kidneys ache. The cramping has died down some but i have intermittent bleeding like a tap having been turned on when walked around or sitting up. I have no idea if this is normal. I was squeezed in to someone elses appointment having not known i needed this so i didn't getthe usual sheet of information others get. Could someone advise me if this is normal? There doesnt seem to be any infection signs
@sillycookie1982 Hi, the length of time to the biopsy result varies. There is a faster route if the findings look suspicious. If not, then maybe a few weeks. Depends on the hospital.
Regarding your bleeding, this can occur for a week or two, and should gradually get lighter. However if things are getting worse, rather than better (pain, bloating, vomiting), it is probably best to be checked over at the hospital or your GP.
I had one yesterday with Kaiser and it was a wonderful experience!! Very easy , the nurses were so kind and helpful , I bled just a tiny bit after , no cramping . The procedure did hurt but not to bad . Over all it was good
Thanks for sharing your experience. Glad it went well!
Was it with anesthesia?
@@drgailbusby WHERE IS SHE LOCATED
Hi dr.gail, I've had a colposcopy before without pain. Is that a good indication i can tolerate a hysterscopy with biopsy?
@ThatsSSoooNiya hi. They are completely different investigations. A colposcopy looks at the cervix from outside, whereas in a hysteroscopy the telescope goes higher up, through your cervix into your womb.
Whether a woman ends up with an empathetic consultant like you (or not) and whether they’re one of the many women who experience excruciating pain (or not) is unfortunately something they won’t discover until the day of their outpatients appointment.
I know many women who have been left traumatised and, in some cases, butchered, but it saves the NHS money to tell them to take Paracetamol beforehand (rather than having it under a general anaesthetic - as I understand used to be the norm) so that’s ok
Thanks. That's why I made the video and why it needs to be shared widely.
Education allows advocacy!
I am scheduled to have an outpatient hysterosopy and I am terrified.
As a teacher, one of my subjects is history, including the module on the history of medicine. Why do I feel that women are being expected to travel back in time to an era of pain and fear.?
@@BernadetteGrosse Unfortunately they never left that era.
@@drgailbusbyhi! How long to recover? And how long to have intimate contact?(This is my husband's question 😅😅)
@user-gk2nl6nz6z Hi. Home the same day with GA, as outpatient pain settles quickly to mild cramps in most cases. Walk out of clinic at end of appointment.
Regarding intimacy, until the watery loss settles. About 2 weeks.
Hi. Thank you for thorough explanation.
Is it common to have this procedure for a thick endometrial lining? Mine was a 14. I stopped getting periods 1.5 year ago & have occasional 'light spotting', & also mucus.
Is it possible come day of procedure my lining won't be as thick, & will the dr see that through camera, where she possibly then WONT have to scrape out my whole lining as she said her plan is? She is doing biopsies.
Hi. Yes it is common to have it for a thick womb lining, especially in postmenopusal women. It would be usual to take a biopsy, which is a small sample, not the whole womb lining. A thickened womb lining may also mean the presence of a polyp - which your doctor will be able to see.
Hope this helps and good luck with it!
@drgailbusby thank you for responding so quickly. Yes your answer helped. She did mention scraping my whole lining. Should I be concerned about that & ask more questions?
@tjs5344 if you're unsure about anything, do ask more questions.
Hi Dr.i have an endometrium thickness of 15.it has increased from 8 in the last 7 months.i did a hysteroscopy.i did have polyps and a fibroid.The doctor said she has removed the fibroid and 3 polyps but was not able to remove everything.i have no symptoms at all.i came upon the above during a routine master check up.my doctor is advising removal of uterus.i am very concerned snout removal of uterus as I am afraid it can cause hernia and other consequences.Please advise your opinion.hysteroscopy results came out as non malignant.
Thnx dr I had today this test I m trying 2 nd baby , I reduced my weight now , dr checking me today and no forbids no any adsiue clear my womb they are v happy from uk
@memoonabibi5258 great news!
Can you please tell me what would cause your urethra 1:56 1:57 tube to be tangled
@@Stanfordmom- hi, I don't understand your question. I have not mentioned the urethra in this video.
I’m glad I watched this video, I have made my decision that I will not be having this procedure done. I’ll get some menopause eventually and I already know how to deal with the issues I have so I’m just going to wait it out.
Dr Can i ask out of curiosity have you had this procedure done yourself? Thanks
@lozb1631 Hi, yes I have. I had it done as an outpatient.
@drgailbusby can you give an advice on what to take or do, before, during or after procedure? Do you advise any type of anaesthetic? Thanks
@lozb1631 Hi, it's really up to the individual. There is no right or wrong. I've tried to be clear in the video. I think do what feels right for you.
can this be done during the period?
@TM-vg4mx Hi, ideally it should not be done during a period as the blood within the womb will obscure the view. It can often be done if bleeding is quite light - the very start or very end of a period. Thanks.
@ thanks a lot
Oh heck no…I’m getting general anaesthesia
You can do it with conscious sedation (safer than GA) and still remember nothing. That's what I did.
Hi,
I recently had a transvaginal scan. It was a horrendous experience and I am going in for a hysteroscopy tomorrow. I have no polyps or fibroids, so I know they are taking a biopsy due to a finding of an irregular edge and thickened area of my womb.
I have had 2 knee replacements and a hip replacement and I just could not get into the correct position and felt berrated because of this., I was lying on a normal bed with NO stirrups, this information would have been in my notes.
I have recently just finished a 6 year course of hormonal adjuvant therapy for breast cancer Stage II invasive ductal carcinoma. I felt unheard, due to the constant questioning of my breast cancer and how long I had been on a certain medication. All this information is in my notes this should have been read prior to my appointment,. Having my masectomy was less painful. I got very emotional, as REMISSION is a very safe. and powerful word.
I am now scared for tomorrow and also scarred emotionally from the whole procedure. I am dreading tomorrow as my appointment is not until late afternoon.
I look forward to writing my friends and family review about both procedures after comparing the 2!!
Thank you for your informative video, which is very thorough and knowing now I have a choice to stop if it is too painful is very comforting and I will do just that.
I wish I was seeing you! Any words of wisdom?
I will update you on how I get on.
With many thanks.
@louiseharfleet7346 Thank you for your lovely feedback. Please don't be scared. You should be the boss in that room. It is your body and your choice. If you opt to have an outpatient hysteroscopy, take painkillers about an hour before (Paracetamol and Ibuprofen if safe for you). Have a light meal before as well. Ask what pain relief is available (heat pack, gas and air if needed). Most of all, be prepared to advocate for yourself.
It may be absolutely fine for you, it is in most cases, but if not, ask for a theatre procedure.
Best of luck, you've got this!
What the difference between this & a colposcopy?
Colposcopy is looking at the cervix, whereas hysteroscopy involves passing a thin telescope through the cervix to look inside the womb. In colposcopy, a speculum is used like a smear test and the cervix is looked at through an instrument which is outside the speculum. Biopsies can be taken from the cervix at colposcopy by taking tiny bites of the cervix. Sometimes, a bigger piece of cervix is taken at colposcopy using a loop of wire.
@@drgailbusby ok thanks for explaining . I had both of these done along with a d&c to remove a polyp. I also had thickened endometrial lining. She took the sample & I had the d&c a few days later.
Thank you very much for all of the information ❤
@@austriaperez497 you're very welcome!
Im Post menopausal and went for a general anesthesia hysteroscopy today for removal/biopsy of polyps. The doctor could not get through my cervix.
He wrote: Indication for Surgery: Postmenopausal bleeding, scan found endometrial thickness and a uterine polyp
Procedure:
Position: Lithotomy
Anaesthesia: General Anaesthesia
Findings
Normal looking vagina and vlulva
full inspection of the vagina and vulva done with the vaginoscope good view achieved. No defined cervix noted however the firm area in the anterior
area found .
gently tried to insert the camera through a supposedly cervical os but very stenosed and not able to enter used half size dilators
small cx os to try to dilate but not possible to dilate - almost a frozen wall instead of a pinhole
multiple attempts made.
Ultrasound scan guided dilatation attempted but not successful.
It is very likely that this is not only stemnosed cervix but completely closer cervix and will need an excision of cervix to be able to enter the uterine cavity or
to consider alternative means to check for endometrial health and removal of polyp .
Normal looking cervix
What do you recommend? I did not like that he wrote it was almost a frozen wall instead of a pinhole.
How are you doing? Have they done anything else for you?
I’m glad I watched this video, I have made my decision that I will not be having this procedure done. I’ll get some menopause eventually and I already know how to deal with the issues I have so I’m just going to wait it out.