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Previous very painful cervical biopsy four years ago - and now booked in for another

Jen225
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I had an excruciatingly painful cervical biopsy four year ago after being found  hpv positive with borderline cervical cells.  It was a horrible experience even with lignocaine injections.  I bled  for four weeks afterwards.   I understand it was because I was older ( 64 ) and it was difficult to sample the transformation zone. The biopsy  was totally  clear -and hpv negative.  I was  assured that the consultant felt that she had got a decent biopsy.   I've just had another pap test on follow up - which  is again HPV post and borderline changes, and wonder what I can do to get better pain relief at the colposcopy appointment - am really hoping not to get the same consultant - because the previous experience was so traumatic.  

  • Hello and thanks for your enquiry,

    I can appreciate that this is stressful to think about.

    You may be able to call the clinic admin team, details from your appointment letter, and ask if there is another consultant there that can be assigned to your appointment.

    It may be useful to consider taking a NSAID anti inflammatory, such as ibuprofen, about an hour before your appointment. This would give it some time to work and may help with crampy symptoms after the procedure. It may be possible to request a combination of a topical numbing spray or gel applied to the cervix first, followed by a localized lignocaine injection into the tissue of the cervix. This will depend on how easy it is do, whilst maintaining your comfort.

    For patients who have experienced medical trauma from prior gynaecological procedures, some NHS Trusts can arrange for the colposcopy to be performed under conscious sedation or general anaesthesia. This typically requires a specific request ahead of time, which might require re-booking the appointment into a dedicated hospital theatre slot.

    Having conscious sedation, which is oral or intravenous (into the vein), may be easier to request than having an anaesthetic. A short acting low dose oral sedative tablet can be prescribed to take just before the appointment and the procedure. But this would need to be arranged before the day of the appopintment, and prescribed by your GP, or the colposcopy team. 

    I hope this helps,

    Best wishes,

    Vanda 

  • Offline in reply to CRUK Nurse Vanda

    Hello Vanda, thank you for the advice.  I will contact the colposcopy team, that is helpful and useful.  What is quite scary is that I had more than one lignocaine injection into my cervix for the exceptionally painful biopsies - I had to cough several times so I know there was more than one, 4-6 I think.  I understand that it may have been more painful  because the consultant  was trying to get good biopsies of my transformation zone and I was 64 , so older, and with vaginal atrophy so more difficult to do and more painful.. I had also been using vaginal estrogen beforehand.  The consultant was apologising, but not stopping. Which was  a horrible experience in itself - it felt quite barbaric. I'm just so shocked about the lack of sufficient pain relief.   When I went to the dentist years ago, when I needed an injection for a root canal, the lignocaine was administered and then I had to sit in the waiting room until it had taken effect - but during a cervical biopsy the injection is given and the biopsy done without pausing - is it even possible for it to take effect straightaway?   I've read that gas and air is a possibility too.  Does conscious sedation work? Or are you just doped out and not able to say that you're in pain?  It sounds a bit like the pain is in your head, and you're just being treated for anxiety, which feels like a way of gaslighting the very real pain of the biopsy.   I understand some women don't experience pain from a cervical biopsy though - or historically are we just expected to put up with it? There doesn't seem to be much research on pain relief for cervical biopsies ( although hysteroscopy without anaesthesia has received more attention since being raised in Parliament).

    I will get in touch with the colposcopy unit on Monday and find out what my options are. Thank you. 

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