Salisbury Foundation Trust


Internal Reference Number: FOI_4957

Date Request Received: 18/03/2019 10:28:44

Date Request Replied To: 10/04/2019 10:47:33

This response was sent via: By Email

Request Summary: Choice and pain relief in hysteroscopy

Request Category: Private Individuals

Question Number 1:
a) Have your hysteroscopists read the following statement issued by the RCOG in December 2018 - Y/N?

b) Have your hysteroscopy managers read the following statement – Y/N?

The British Society for Gynaecological Endoscopy published this statement in December 2018:
"Diagnostic hysteroscopy is a commonly performed investigation; it is safe and of short duration. Most women are able to have the procedure in an outpatient setting, with or without local anaesthesia, and find it convenient and acceptable. However, it is important that women are offered, from the outset, the choice of having the procedure performed as a day case procedure under general or regional anaesthetic. Some centres are also able to offer a conscious sedation service in a safe and monitored environment. It is important that the procedure is stopped if a woman finds the outpatient experience too painful for it to be continued. This may be at the request of the patient or nursing staff in attendance, or at the discretion of the clinician performing the investigation."
Answer To Question 1:
a) Yes
b) Yes
Question Number 2:
Are ALL of your hysteroscopy patients from the outset routinely offered the choice of having hysteroscopy as a day case procedure
a) under GA – Y/N?
b) under regional anaesthetic – Y/N?
c) with IV sedation?
Answer To Question 2:
a) Yes
b) Yes
c) Yes
Question Number 3:
Do your hysteroscopy consent forms contain tick-boxes to enable a patient to choose
a) GA – Y/N?
b) regional anaesthesia – Y/N?
c) IV sedation – Y/N?
Answer To Question 3:
a) Yes
b) Yes
c) Yes
Question Number 4:
Have all your outpatient hysteroscopy teams received written instruction to monitor the patient throughout the procedure, to ask if she is experiencing pain, and to stop if the patient asks or is showing signs of severe pain or distress – Y/N?
Answer To Question 4:
Question Number 5:
Do all your hysteroscopy clinics routinely record ALL patients’ VAS pain-scores
a) as hysteroscope passes through the cervix – Y/N
b) at biopsy – Y/N?
Answer To Question 5:
a) No
b) No
Question Number 6:
Does your hysteroscopy department send all its patients the RCOG’s Patient Information Leaflet, published on its website - Y/N?
(Link to be entered)
Answer To Question 6:
NO - we send local leaflet
Question Number 7:
Does your hysteroscopy department intend to start using the RCOG leaflet – Y/N?
If so, in which month/year?
Answer To Question 7:
NO - we send local leaflet
Question Number 8:
If your hysteroscopy department uses its own Patient Information Leaflet, please may I have a link to it?
Answer To Question 8:
Question Number 9:
Does the leaflet include ALL the key points listed (below) by the RCOG – Y/N?
Key points
• Outpatient hysteroscopy (OPH) is a procedure carried out in the outpatient clinic that involves examination of the inside of your uterus (womb) with a thin telescope.
• There are many reasons why you may be referred for OPH, such as to investigate and/or treat abnormal bleeding, to remove a polyp seen on a scan or to remove a coil with missing threads.
• The actual procedure usually takes 10–15 minutes. It can take longer if you are having any additional procedures.
• You may feel pain or discomfort during OPH. It is recommended that you take pain relief 1–2 hours before the appointment.
• If it is too painful, it is important to let your healthcare professional know as the procedure can be stopped at any time.
• You may choose to have the hysteroscopy under general anaesthetic. This will be done in an operating theatre, usually as a daycase procedure.
• Possible risks with hysteroscopy include pain, feeling faint or sick, bleeding, infection and rarely uterine perforation (damage to the wall of the uterus). The risk of uterine perforation is lower during OPH than during hysteroscopy under general anaesthesia.
Answer To Question 9:
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