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

Authors

  • Manoj Kumar Tangri Department of Obstetrics and Gynecology, Command Hospital (SC), Pune, Maharashtra, India
  • Prasad Lele Department of Obstetrics and Gynecology, Command Hospital (SC), Pune, Maharashtra, India
  • Krishan Kapur Department of Obstetrics and Gynecology, Command Hospital (SC), Pune, Maharashtra, India
  • Anupam Kapur Department of Obstetrics and Gynecology, AFMC, Pune, Maharashtra, India
  • Neelam Chhabra Department of Obstetrics and Gynecology, Command Hospital (SC), Pune, Maharashtra, India
  • Binay Mitra Department of Obstetrics and Gynecology, Command Hospital (SC), Pune, Maharashtra, India
  • Monica Saraswat Department of Obstetrics and Gynecology, AFMC, Pune, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20164642

Keywords:

Office Hysteroscopy, Uterine Cavity evaluation, Vaginoscopic approach

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.

Metrics

Metrics Loading ...

References

Bettocchi S, Selvaggi L. A vaginoscopic approach to reduce the pain of office hysteroscopy. J Am Assoc Gynecol Laparosc. 1997;4:255-8.

Paschopoulos M, Paraskevaidis E, Stefanidis K, Kofinas G, Lolis D. Vaginoscopic approach to outpatient hysteroscopy. J Am Assoc Gynecol Laparosc. 1997;4:465-7.

Cicinelli E. Diagnostic mini-hysteroscopy with vaginoscopic approach: rationale and advantages. J Minim Invasive Gynecol. 2005;12:396-400.

Bettocchi S, Ceci O, Vicino M, Marello F, Impedovo L, Selvaggi L. Diagnostic inadequacy of dilatation and curettage. Fertil Steril. 2001;75:803-5.

Committee on practice bulletins - gynecology. Practice bulletin no.136: management of abnormal uterine bleeding associated with ovulatory dysfunction. Obstet Gynecol. 2013;122:176-85.

Marsh F, Kremer C, Duffy S. Delivering an effective outpatient service in gynaecology. A randomised controlled trial analysing the cost of outpatient versus day-case hysteroscopy. BJOG. 2004;111:243-8.

Di Spiezio A, Calagna SG, Di Carlo C. Tips and tricks in office hysteroscopy. Gynecol Minimal Invas Ther. 2015;4(1):3-7.

Goldstein SR. Modern evaluation of the endometrium. Obstet Gynecol. 2010;116:168-76.

Di Spiezio S, Bettocchi A, Bramante S, Guida S, Bifulco M, Nappi C. Office vaginoscopic treatment of an isolated longitudinal vaginal septum: a case report. J Minim Invasive Gynecolm 2007;14:512-5.

Pontrelli G, Landi S, Siristatidis CH, Di Spiezio Sardo A, Ceci O, Bettocchi S. Endometrial vaporization of the cervical stump employing an office hysteroscope and bipolar technology. J Minim Invasive Gynecol. 2007;14:767-9.

Di Spiezio Sardo A, Bettocchi S, Spinelli M. Review of new office-based hysteroscopic procedures 2003-2009. J Minim Invasive Gynecol. 2010;17:436-48.

Hill MCW, Broadbent JAM, Baumann R. Local anesthesia and cervical dilatation for out-patient diagnostic hysteroscopy. Obstet Gynecol. 1992;12:33-7.

Cronje MS. Diagnostic hysteroscopy after postmenopausal uterine bleeding. S Afr M J. 1984;66:773-4.

Walton SM, Macphail S. The value of hysteroscopy in postmenopausal and perimenopausal bleeding. J Obstet Gynecol. 1988;8:332-6.

Dinić SPT, Kopitović V, Antić V, Stamenović S. Role of hysteroscopy in evaluation of patients with abnormal uterine bleeding. Acta Facultatis Medicae Naissensis. 2011;28:3.

Dongen HV, De Kroon CD, Jacobi CE, Trimbos JB, Jansen FW. Diagnostic hysteroscopy in abnormal uterine bleeding: a systematic review and meta-analysis. BJOG. 2007;111:664-75.

Toki T, Oka K, Nakayama K, Oguchi O, Fujii S. A comparative study of pre-operative procedures to assess cervical invasion by endometrial carcinoma. BJOG. 1998;105(5):512-6.

American College of Obstetricians and Gynecologists Committee on Gynecologic Practice: Tamoxifen and endometrial Cancer. Committee opinion 601. ACOG 2014; Washington, DC.

Royal College of Obstetricians and Gynaecologists. Guidelines on Postmenopausal thick endometrium (Query Bank). RCOG 2014; London UK.

Prabhakaran S, Chuang A. In office retrieval of intrauterine contraceptive devices with missing strings. Contraception. 2011;83(2):102-6.

Downloads

Published

2016-12-20

Issue

Section

Original Research Articles