"Hysteroscopy"

About: Airedale General Hospital / General surgery

(as the patient),

I am a thirty-year-old woman with Polycystic Ovary Syndrome. I experience irregular, heavy, and very painful periods. In February, I saw a gynaecologist at Airedale General Hospital, Keighley, West Yorkshire, who arranged for a hysteroscopy to be performed. The gynaecologist gave me a leaflet, which explained that ‘a slight cramping feeling within the lower part of the tummy, not unlike period pain’ may be felt during the procedure. The word ‘gently’ appears twice in the leaflet’s description of the hysteroscopy. I was led to believe that the procedure was not unlike a routine smear test.

I arrived at Airedale Hospital for the hysteroscopy yesterday, with my female partner as support (although I did not feel particularly anxious or worried). After a 40-minute wait, my partner and I were led into a room where we met two nurses and a consultant. The consultant explained the potential risks: there was a slight chance that my bladder or bowel may be ruptured during the procedure and that I would be taken for emergency surgery and a blood transfusion. Still, I did not feel particularly anxious. I signed a form, then we were led into a larger room where another nurse was waiting. I was asked to undress behind a curtain and to sit on a hard reclined chair with raised leg supports at either side. My partner was told that she could sit in a chair next to me and hold my hand, although the nurse ‘would usually sit there’. I should say here that all of the nurses and the consultant were very kind and supportive before and during the procedure.

After the speculum had been inserted, the consultant attempted to pass the hysteroscope through my cervix. The pain was considerable although not yet unbearable – I experienced sharp stabs with cramps all the way up my abdomen. My partner was attempting to distract me, and I did not really understand what was happening at this stage, but there was clearly something wrong. The consultant called for different instruments. Each instrument was pushed into or through my cervix. The pain was absolutely excruciating. The nurses were lovely – reminding me to think of my holiday, telling me how brave I was and how well I was doing – but in the end I couldn’t help moaning in pain. It felt as though the water used to dilate my womb was pouring down my bottom and legs, but to be honest I didn’t care about my dignity at this stage. I was in agony.

My legs began to shake uncontrollably. The consultant called for ‘a local’. I cannot understand why I was not given any anaesthetic until this stage. My partner was holding my hand and I was trying to grit my teeth (or even say that I was ‘fine, thanks’ when asked), but staff were clearly aware that I was suffering very badly. The consultant told me that she would take a biopsy ‘a few times’. Each time, I gasped in pain. I truly cannot describe how awful it was.

After the biopsies had been taken, the consultant finally succeeded in achieving ‘good pictures’ of the inside of my womb. The procedure had taken around 25 minutes.

Towards the end of the procedure, one of the nurses had asked if my partner and I would like a cup of tea – they’d like me to stay behind so they could check I was OK. She also gave me a sanitary towel. I stood up after the procedure, and saw bright red blood on the chair. I wiped myself and found that I was still bleeding. I began to get dressed, but was suddenly overcome with nausea and dizziness. I sat back down in the chair and rested my head. My partner called for a nurse – my reaction was ‘completely normal’, they said. The nurse hooked me up to a monitor and found that my heart rate had dropped to below 60 beats per minute. The consultant came to check that I was OK. Stroking my legs, she told me how brave I had been. She said that it was not trivial, that they see this every day and that if they told women how painful it would be, they would refuse to come.

When I finally felt well enough to stand, we were led back into the first room where the consultant told me that she had not seen any worrying features on the screen. We were then taken to a separate room with comfortable chairs and two cups of tea. I felt shaken and tearful.

I spent the evening and the night in pain. I still feel unwell: I have pains in my stomach and am bleeding. I feel very emotional. I think that I am in shock.

No woman should have to undergo this procedure without general anaesthetic. I am absolutely appalled that this is happening.

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Responses

Response from Airedale General Hospital

We are sorry you found the procedure you underwent painful and distressing.

Our Clinical Director advises that this is a routine procedure which most people experience without undue discomfort.

If you are still concerned please do not hesitate to contact our PALS service on 01535 294019 or your consultant’s secretary directly.

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Update posted by Hannah30 (the patient)

This response is not at all helpful. Your Clinical Director's claim that 'most people experience [this procedure] without undue discomfort' is not at all consonant with the way that hysteroscopies are carried out at AGH. It is standard, as I understand it, for a third nurse to be present 'to hold the patient's hand', and for cups of tea to be provided, post-procedure, for shock. Many women, as I understand it from a member of your staff, feel nauseous and faint after undergoing this procedure due to dramatic changes in blood pressure and heart rate.
I would like to point out that there is currently no system of monitoring levels of patients' discomfort with patients' knowledge or consent. How would my level of discomfort have been rated, I wonder?