Outpatient Hysteroscopy for the Management of Intrauterine Disorders: Feasibility, Effectiveness and Safety For 3000 Cases

Study objective: To assess the feasibility, effectiveness and safety of outpatient hysteroscopies performed in an Office Hysteroscopy Unit.

Design: Retrospective observational study of prospectively collected data in an office hysteroscopy unit database (Canadian Task Force II-2). The study was approved by our hospital’s ethical committee.

Setting: Tertiary care university hospital.

Patients: Included consecutively were 3000 patients who underwent outpatient hysteroscopy between May 2008 and October 2019.

Interventions: Outpatient hysteroscopy was performed using a rigid 5-6 mm diameter device when indicated for diagnostic or therapeutic purposes.

Measurements and Main Results: Feasibility, effectiveness and safety results were evaluated. Outpatient hysteroscopies were successfully performed in 94.5% of cases, with failed hysteroscopies amounting to just 5.5% of cases. Effectiveness was 87.4%, with just 12.6% of women rescheduled for hysteroscopy in a surgical setting. There were no complications in 99% of patients; the main complications otherwise were vasovagal response and uterine perforation (28 and 2 cases, respectively), neither of which required further intervention other than antibiotic treatment and clinical observation.

Conclusion: The results for 3000 outpatient hysteroscopies indicate that office hysteroscopy is a feasible, effective and safe approach to managing most cases of common benign intrauterine disorders. These encouraging results would suggest that outpatient hysteroscopy should be a first line approach to the management of intrauterine conditions.

Keywords: Effectiveness; Feasibility; First line treatment; Office hysteroscopy; Outpatient hysteroscopy; Safety