Abstract
INTRODUCTION:Traditionally, hysteroscopy has been a hospital-based procedure under general anesthesia however the emergence of small diameter hysteroscopes and the vaginoscopy approach has allowed it to be transitioned to the office setting. This study compares office versus OR operative hysteroscopy with respect to success rate and operative time.
METHODS:Retrospective chart review of 66 hysteroscopies performed in the OR under general anesthesia compared to 22 in office hysteroscopies performed without anesthesia using the vaginoscopy 'no touchʼ technique.
RESULTS:Patientsʼ characteristics were similar in both groups. The procedure was successfully completed in 80% (18/22) of the in-office group and 100% (66/66) of the OR group. Hysteroscopic office procedures indications were2 (9.1%) postmenopausal bleeding, 5 (22.7%) retained IUD, 7 (31.8%) for suspected polyp, 8 (36.4%) for abnormal uterine bleeding. Hysteroscopic OR indications were2 (3.0%) abnormal uterine bleeding, 3 (4.5%) retained IUD, 11 (16.7%) postmenopausal bleeding, 50 (75.8%) suspected polyp. Mean operative time for in office hysteroscopy was 28.3 SD ±3.3 minutes versus 88.4 SD ±23.2 minutes (p<0.001). There was no complication in either group.
CONCLUSION:In office hysteroscopy without anesthesia, using the vaginoscopy “no touch” technique, had a significantly less operative time when compared to those performed in the OR. Encouraging practitioners to adopt in office hysteroscopy would allow to eliminate anesthesia risks and optimize utilization of OR time which could represent increased patientʼs satisfaction and decreased cost.
