"Hysteroscopy & biopsy without anesthesia"

I had a hysteroscopy and a biopsy yesterday for symptoms including intermenstrual bleeding, post-coital bleeding, and severe period pain.  I'm 28 years old and was referred to a local hospital for the procedure.

When I met with the consultant before the procedure, I advised her of previous issues that might impact the procedure and was, at this point, offered to have it under general anesthetic instead.  As I had read (everywhere) that most women only experience mild discomfort, I said I was happy to proceed with the procedure awake, and without anesthesia, as the NHS website suggests most women have it.

The first step was to look around the uterus with the tubes and the camera and, as it entered my cervix, proved to be the most painful thing I have ever experienced.  

The consultant then removed the equipment and said she had found a polyp.  She explained that I could have this removed under general anesthetic, but that it did need to be removed.  She then explained that she still needed to take a biopsy from the endometrial lining, which I agreed to, based on her and her colleagues explaining that this wouldn't be as painful as the initial step where the camera has to have a look around.

When they put the speculum in, I was already experiencing serious pain, and the nurses around me can attest to the fact that I was in tears.  When she began the procedure again by inserting the tools through the cervix, I had to ask her to stop because I was in such severe pain.  However, despite continually asking the consultant to stop, she carried on snipping away, and then removed what she thought was the polyp. 

She explained that it wasn't actually a polyp, but rather something filled with blood which could have been related to my recent period.  She also explained that she knew she could get it out while doing the biopsy so decided to do so. 

I was crying my eyes out at this point and was mostly glad that the procedure was over; however, when I spoke to my mum (who is a nurse) and my flatmate (who is also a nurse, and who works at UCLH), they were both horrified that:

1) The consultant had gone against my wishes and removed the "polyp" while I was awake.

2) The consultant hadn't stopped the procedure when I asked her to, repeatedly, even just for a few moments while I regained composure.

3) There was no additional consent form during the process for me to sign, saying that I was happy for the "polyp" to be removed there and then.

Ultimately, I am glad everything has been removed and I do not have to have a second operation, but I would have liked to have been treated like a human being and had this conversation with the consultant - and not have been totally ignored during the procedure.

Additionally, I do feel like the NHS guidance should be updated to properly describe the extent of the pain that some women feel.  Both of my mum and my stepmum have had a hysteroscopy and polypectomy, and these were both done under general anesthetic.  I think it's obscene that this kind of work is performed without any kind of pain relief to begin with, and that there seems to be no regulation across the health service, with different hospitals choosing to perform these procedures under anesthetic and others preferring to do them while the patient is awake.

The whole experience was very invasive and traumatic, and I would advise anybody going to have one of these procedures to seriously consider whether or not they are happy having this done while awake.