Hysteroscopies are common surgical procedures performed on tens of thousands of patients annually in England, used to diagnose and treat various uterine conditions including heavy bleeding, fibroids, and cancer screening. The procedures involve inserting a thin surgical instrument through the vagina and cervix to examine or treat the womb, typically performed on an outpatient basis under local anesthesia rather than general anesthesia.
Patients and advocacy groups have raised concerns about inadequate pain management during these procedures. Beth Harris, who underwent a hysteroscopy earlier this year to remove a fibroid, described the experience as extremely painful despite being assured by her physician that local anesthesia would prevent discomfort. Harris reported witnessing other patients emerging from the procedure in distress, and she herself experienced significant pain during the procedure despite receiving local anesthetic injection.
Hysteroscopy Action, a campaign group formed in 2010, has been advocating for over 16 years for improved patient care standards. The group seeks to ensure all patients receive full informed consent about potential pain risks and access to multiple pain relief options, including local anesthesia, gas and air, conscious sedation, epidural, and general anesthesia when needed. According to the campaign group, pain management options currently vary significantly across different healthcare facilities.
A Women’s Health Strategy released in April included provisions calling for informed consent and expanded pain relief choices for hysteroscopy patients. However, campaign advocates report that implementation efforts have stalled following the strategy’s announcement. Healthcare guidelines recommend that the majority of diagnostic procedures occur in outpatient settings, a shift from earlier practice that prioritized general anesthesia, though this transition has created questions about whether adequate pain management accompanied the move to office-based procedures.
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