"Poor Pre-Hysteroscopy Information"

This is not about the outpatient procedure itself, it's about the online leaflet Queen Alexandra Gynaecology Department produces and the information given to hysteroscopy patients beforehand.

As there was less than 48 hours between the hospital ringing me and my appointment I did not receive an information leaflet in the post, nor was I told I could find one online.

The person who made the booking said I might experience some mild pain similar to period pain and told me to take 2 paracetamol or whatever you use for a headache an hour beforehand.

I did find the QAH Gynaecology Outpatients Hysteroscopy information leaflet online and it gave the same information, stating you may feel discomfort like period pain and many women feel nothing at all. However, the British College of Obstetricians and Gynaecologists and a general NHS information download both acknowledge that 1 in 3 women experience severe pain during a hysteroscopy.

Nowhere in the QA hysteroscopy leaflet does it warn women that there is a 33% chance they will experience severe pain. How can women give fully informed consent if they are not aware of all possibilities, including severe pain?

Nor does the leaflet state that women are entitled to ask for this procedure to be done under general anaesthetic without having to attempt the procedure in outpatients first.

It does say that before you give consent it's important that you understand what you're consenting to, and if you don't understand ask - more detailed information is available on request.

It should not be the patient's responsibility to have to ask for information. If women reading that leaflet trust that they are being told everything they need to know and think they are going for something that is no more uncomfortable than a smear test with a bit of mild discomfort, why would they ask?

The leaflet also states that consent can be implied, i.e. rolling up your sleeve and presenting your arm to the doctor implies consent for your blood pressure to be taken. So by this logic, does undressing and climbing into the chair imply consent to a hysteroscopy?

I believe this leaflet falls far short of the BCOG best practice and, in my opinion, deliberately downplays any possibility of pain to lull women into going along with outpatient hysteroscopy.

For the record, my hysteroscopy was extremely painful and had to be stopped because I was in too much pain to carry on.  The only way the pain I experienced could be likened to period pain was because it occurred in the same part of my body.  No wonder women are traumatised by this procedure, they go in expecting nothing more than a slightly uncomfortable smear test totally unaware that 1 in 3 of them will end up in severe pain.

I believe this leaflet needs a serious re-write.