Women have been left in extreme pain from an invasive procedure that’s been described as the “next big medical scandal”.
They’ve submitted their accounts to a campaign group about their experience with hysteroscopy – where a needle is inserted into the womb to detect cancer.
Some women have been left with post-traumatic stress symptoms and feel unable to have intimate relationships
with partners while others avoid vital examinations such as smear tests.
The Campaign Against Painful Hysteroscopy (CAPH) has collated more than 3000 accounts of “pain, fainting and trauma during outpatient hysteroscopy” throughout the UK – including more than 40 so far from Scotland.
CAPH said female patients are being subjected to barbaric levels of pain and claim hospitals prioritise efficiency and cost-cutting over their needs and welfare.
The group believes the issue could become as bad as the vaginal mesh scandal, which saw women left in severe pain and with life-changing side effects after being treated with polypropylene mesh implants for stress urinary incontinence and pelvic organ prolapse.
Katharine Tylko, of CAPH, said: “Severely painful outpatient hysteroscopy is the next medical scandal after vaginal mesh. Cheap, quick and easy-ish NHS outpatient hysteroscopy without anaesthesia/sedation causes severe pain/distress/trauma to approximately
25 per cent of patients.”
Hysteroscopy is where a needle-like rod with a tiny camera and surgical tools is passed through the cervix into the womb. It is used to detect cancer, pre-cancer and benign abnormalities.
CAPH said information obtained under Freedom of Information reveals not all health boards in Scotland offer all
hysteroscopy patients general anaesthetic initially, leaving some unprepared for what to expect.
The action group is campaigning for all hysteroscopy patients to have written information about the
procedure, including the risk of severe pain, as well as safe and effective pain relief.
Katharine added: “Hysteroscopists should be taught to recognise patients at high risk of severe pain.”
She said many Scottish hospitals are not using the leaflet written by the Royal College of Obstetricians and Gynaecologists (RCOG).
Katharine said: “This leaflet explicitly states that patients may choose general anaesthetic for
hysteroscopy upfront.
“Scottish hospitals are using their own leaflets which downplay the risk of severe pain.”
The RCOG published a document stating one in three outpatient hysteroscopies causes severe pain.
Katharine added: “Women are being misled into expecting ‘mild discomfort’ or ‘period-like cramps’.
“The RCOG makes it clear there are cohorts of patients who are not suitable for outpatient hysteroscopy.”
Scottish Labour’s Jackie Baillie said: “It is not acceptable for anyone to be told they’ll suffer mild pain and then be doubled over in agony with little or no pain relief. There needs to be a proper action plan and guidelines for clinicians so women are not left in pain.”
The Scottish Government said: “We know that inequalities have existed in women’s health for a long time and women’s health is much broader than the specific priorities set out in the first Women’s Health Plan for Scotland. The newly appointed Women’s Health Champion will lead this work to help ensure our wider healthcare system is more responsive to all of the health needs of women in Scotland.”
Health board chiefs defended the provision of outpatient hysteroscopy.
Dr John Keaney, of NHS Lanarkshire, said: “All women are counselled prior to the start of the procedure about the options for investigation with the pros and cons of each approach. Specifically, hysteroscopy under local anaesthetic versus general anaesthetic is discussed.
“All women are given a leaflet on how to provide feedback on their experience and they are invited to give feedback at the time by form on an iPad.”
NHS Greater Glasgow and Clyde said: “While studies show it is a safe and well-tolerated procedure, our clinical teams recognise it can be a stressful procedure for some patients. At all times they follow best practice in line with national guidelines in providing post-operative care.”
Dr Tracey Gillies said that nearly 2500 hysteroscopy appointments were provided last year in NHS Lothian.
She said: “Women are given the option of local anaesthetic or general anaesthetic as a matter of course, and in line with national guidance, and their analgesic needs are continually reviewed and adapted throughout the procedure to ensure they remain comfortable.”
Margaret Cannon, from Rutherglen in Lanarkshire, told how she had an “excruciatingly painful” hysteroscopy at Stobhill Hospital in April 2020 without anaesthetic or analgesia.
The 57-year-old mum of two said she was left “feeling traumatised, violated and in shock”.
She said: “I am a qualified nurse and midwife, so have good insight into how all the medical and nursing professionals failed me. I had been told to expect mild cramp and I kept thinking, ‘What’s wrong with me that I can’t tolerate the pain?’ I felt violated and assaulted.”
She felt so strongly about her experience that she complained. When she finally received a response, she said it “was dismissive and none of my points were addressed”.
Margaret persisted and eventually had a meeting with the Greater Glasgow and Clyde health board.
She added: “Had I not made an official complaint, they would have wrongly assumed I had tolerated this barbaric procedure well. How many other women have gone through what I went through?”
Glasgow pensioner May Hooper revealed how she had an “agonising” hysteroscopy at Stobhill Hospital last July.
She has since been referred by her GP for trauma counselling.
She has raised a formal complaint with NHS Greater Glasgow and Clyde, which initially dismissed her concerns, she said.
May escalated the complaint and met a senior consultant, who again failed to ease her concerns.
The 72-year-old said she was invited to an appointment at Stobhill Hospital for an assessment of her symptoms.
May said she was told she would feel “mild cramp” as the procedure began but, because of hearing difficulties, she couldn’t understand what the doctor was saying or exactly what was to happen.
She said: “It was commented upon that my cervix was very tight and this was making examination difficult. I thought I’d lose
consciousness.
“When asked if the examination could
continue, I reluctantly agreed because I was so afraid of what the ultrasound findings might mean. Another attempt was made and I was asked to breathe through the pain – I simply couldn’t do it. I doubt anyone could.
“The specialist nurse asked if the procedure should stop. I couldn’t endure any more. The doctor left
saying that a general anaesthetic would be organised because I couldn’t ‘tolerate’ the procedure.”
May said at one point she passed out as a result of the pain and later vomited. She insists that at no time was she offered analgesia and believes the procedure was carried out without her being able to give properly informed consent.
She added: “I have never experienced such agony. I had no information about what it meant to consent to the procedure or if I had choices. I was traumatised and continue to shudder when I think of what can only be described as a torturous, brutal experience."
A spokesman for the NHS board said: “While we cannot discuss the circumstances of any individual patient’s care, we would like once again to apologise to Miss Hooper for any distress she has experienced.”
He added: “Miss Hooper’s case is the subject of a formal complaint and NHSGGC staff have met her previously to discuss her concerns. However, if she would like to meet us again, we would encourage her to contact us.”
May’s MP Patrick Grady has taken up her case with Health Secretary Humza Yousaf.
She has since had a hysteroscopy under general anaesthetic at Glasgow’s Victoria Hospital where she said the surgeon explained the procedure in detail and she was fully informed about consent.
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