Role of office hysteroscopy in gynecology: retrospective observational study at a tertiary care hospital

Abstract

Background: Hysteroscopy being the gold standard for evaluation of uterine cavity can be utilized for varied gynaecological indications. Conventionally, hysteroscopy is performed under general anaesthesia but with technical advances over years, it is now possible to do the procedure in ambulatory office setting with same diagnostic accuracy. Aim of this study was to assess the role of hysteroscopy as a diagnostic tool in office setting, to evaluate various gynaecological conditions.Methods: Study performed retrospective analysis on 1920 patients who underwent office hysteroscopy between Jan 2011 to Apr 2015, at outpatient department of a tertiary care centre at Maharashtra, India. The procedure was done in office setting without any sedation or anaesthesia. Approach used was vaginoscopic free hand technique with minimal instrumentation and the findings were documented after evaluation of uterine cavity, ostea and endocervical canal.Results: Office hysteroscopy could be successfully performed in 1920 out of 1938 patients. Most common indications were primary infertility (38.0%), secondary infertility (11.2%), abnormal uterine bleeding (36.6%) and postmenopausal bleeding (8.3%). The procedure done in office setting was tolerated well. The procedure was also used for evaluation in patients with breast and endometrial carcinoma.Conclusions: Office hysteroscopy by vaginoscopic approach is a simple and convenient method for evaluation of uterine cavity and cervical canal. It has the potential to come out from formal operation theatre to more patient friendly outpatient department.

Three Thousand Cases of Office Hysteroscopy: See and Treat an Indian Experience

“…Majority 1435 (76.3%) of those undergoing diagnostic office hysteroscopy had a normal uterine cavity, while 445 (23.6%) had abnormalities. This was as per the study by Tangri et al [7] wherein 94 (59.11%) had a normal uterine cavity, whereas 65 (40.8%) showed abnormalities.…”

“…In the study by Tangri et al [7], abnormalities detected were endometrial polyps (24.5%), polypoidal hypertrophic endometrium (8.8%), submucous fibroids (3.1%), hyperaemic cavity (1.2) and others.…”

“…Hysteroscopy has changed the management of intrauterine pathologies in women with abnormal uterine bleeding (AUB) [7].…”

Experience of hysteroscopy in a rural tertiary care center of Haryana, India

“…Now it's the time to shift from sticking only to histopathology to hysteroscopy for diagnosis of intrauterine pathologies even in postmenopausal women. Daniilidis 1.8% Table 6 shows the comparison of pattern of hysteroscopy findings of our study with other two studies done by Tangri et al and Kathuria et al 3,6 Complications due to hysteroscopy are relatively rare events. They usually occur when contraindications for procedure are ignored, proper surgical techniques are not followed or equipment is used in an inappropriate fashion, but they can also occur even if the procedure has been performed correctly on well-chosen patients.…”

“…2 Today is the era of office hysteroscopy because of high patient satisfaction rate, reduced need for anesthesia, decreased cost and more compliance. 3 That is why introduction of hysteroscopy in gynecological practice is the need of time. Along with its multiple advantages it has long learning curve and require specific training which create hurdle for the beginners.…”