"Womb biopsy"

I had been referred to gynaecology having had a few years of struggling with heavy periods. I received notification that this had been passed to a company called ‘Healthharmonie’. I received a call and was provided a date for ultrasound followed by appointment with consultant. The date was less than ideal as would be period start date. However no alternative was available and I was reassured this would not be an issue for them. A confirmation letter was sent detailing the ultrasound procedure and requirement to have a full bladder.

I arrived for appointment, and ultrasound was done. This was done very professionally and the sonographer was pleasant and explained the process throughout. There was an assistant also in the room, and likewise courteous and professional.

After the ultrasound I was returned to waiting room and not long after called through to see the consultant. On arriving in the room, there was the usual politeness however observed the nurse to be sat a long way away from the desk and consultant sat at her desk with her back to the nurse and proceeded with the consultation. There were questions to take a brief history although this was cut short as consultant appeared less than interested and rather curt. I felt that the consultant rather I just answered yes/no to a set of questions. The need for referral was also questioned at one point commenting that the ‘coil’ should have been advised. I was asked about previous colposcopy and kept repeating the question asking if I had had treatment. I explained what I had done over the years but this was dismissed and the consultant just typed the note and stated back ‘no treatment then’. Sometimes I struggled to understand what the consultant was asking and the nurse assisted me by filling in words I couldn’t quite hear. An example of this was asking if I had psoriasis; however when the nurse assisted, the consultant cast a very stern glance at me. I was not trying to be awkward I just couldn’t hear correctly. The consultant asked if I’d had a scan, I was now confused as this has just happened only 5 minutes prior so just answered ‘yes, just now’. This was replied with an ‘I know’. A very strange question and response I thought. The consultant went on to explain that there was nothing found except a polyp to the cervix which is of little concern and should have been picked up at a smear, however would take a look. I asked about the scan as the sonographer has located a small possible fibroid as well as the polyp. The consultant replied this was of little consequence. A comment was also made and implied my fault for not keeping up with my smears, to which I commented it had only become due recently. I was then asked to go over to the couch and undress from waist down so she could ‘have a look’. The curtain was drawn and nurse advised to use paper to cover over. The consultant came over and proceeded with the examination. There was no reassurance or explanation and the speculum was inserted very roughly and felt instant pain due to skin condition having the speculum cause tearing. This was expanded and again was very uncomfortable. The recent ultrasound had asked for full bladder and this was now causing some uncomfortableness. The consultant then proceeded with the examination, none of which was explained. I could feel pulling and something was added to a jar, again no explanation. This was then promptly followed by a comment ‘you will feel a pinch’ when something was inserted, this caused agony now. I had heard the consultant ask the nurse for the ‘dilator’ but that is all I was heard. I’ve not had pain like it and whilst I haven’t given birth (pointed out to me on a few occasions), I have had kidney stones. Pitying glances were given by the nurse and the consultant proceeded with what I can only explain as a ‘ramming exercise’ against my cervix. Various comments were made by the consultant at this time, many of which were said in a tone that made it feel as if it was your fault. You have a high cervix, you cervix is very tight, a usual problem for people like you who don’t have children, can’t see what I’m doing for the blood, shouldn’t have booked when on period. I couldn’t bear the pain and had started to move. The nurse was instructed by the consultant to come and hold the speculum (and me) whilst she continued trying to break through. This was repeated, where the nurse would discard one instrument and provide another and returning to hold me with the speculum whilst writhing in pain. The pain was intense and increasing, there seemed little I could do other than moan with the pain. I did not want to shout out, as you are made to feel as if the pain is your own fault. The consultant then proceeded to discuss the lack of the ‘green tip’ piece of equipment missing from the selection of ‘ramming rods’. This discussion held as if I wasn’t even present in the room. The nurse explained they don’t keep them here to the consultant and brief exchange of words and glances between consultant and nurse. In some way I was relieved, this surely must be the end? The consultant finally gave up and explained that I’d have to go to hospital so that she would have all her equipment available to her. I was asked very brusquely to redress. The consultant returned to computer and typed up some notes. I was asked if I want to go to Stoke or Princess Royal (PRH) in Telford and having confirmed PRH then passed me a ‘letter’ explaining that she was passing me this in case they don’t know what I’ve been referred for. I asked what was to happen next and was told to just wait for the referral. I left and returned to my car. My husband had text to ask how it had gone and a simple reply ‘I feel brutalised’ was what I sent back.

That is exactly how I felt though and still do. I was very sore after and for days. I wasn’t sure if this was normal or not. There was nothing provided in the appointment letter sent about this only the ultrasound. I wasn’t even sure what the ‘procedure’ was. I had to use Google to find out what had even happened to me.

I’ve since learnt that the consultant was trying to carry out a womb biopsy or pipelle procedure to take a sample from my womb. At no point during the procedure, prior or after was this explained. I had not given my informed consent, material risks were not explained. The consultant had asked ‘to take a look’ and had only referred to the polyp. There was no expectation of them to try and take a womb biopsy or go further than the cervix. As I understand all material risks which a reasonable patient would consider important should be explained, no matter how small. This was not done. It was a horrendous experience and wouldn’t wish this on any woman to suffer. I have still to return but have since learnt I’m allowed to have this procedure done with anaesthetic and will push to ensure this is done and with another consultant.