Abstract

Research Article

An audit on outpatient hysteroscopy – cervical dilatation, failure rates and patient satisfaction

Sophie Boyd* and S Lalchandani

Published: 12 January, 2021 | Volume 4 - Issue 1 | Pages: 003-006

Aims: To audit the use of cervical dilators, local anaesthetic, and failure rates in outpatient hysteroscopy over a two-year period in University Hospital Kerry. To review the experiences of women attending the outpatient hysteroscopy clinic (OHC) over a two-year period in University Hospital Kerry.

Methods: Retrospective data review was carried out. Green-top Guideline No. 59: Best Practice in Outpatient Hysteroscopy, published by the Royal College of Obstetricians and Gynaecologists (RCOG), was the standard used for comparison.

Results: Two hundred and twenty women were seen over a two-year period. The average age was forty-eight. The most common complaint being of menorrhagia/irregular bleeding per vaginum (PV).

Local anaesthetic was used in just under one third of cases of which half required cervical dilatation. Most women reported experiencing mild to moderate levels of discomfort however most would opt for an outpatient hysteroscopic procedure again if required.

Discussion/Conclusion: Outpatient hysteroscopy is a well-tolerated and safe procedure. Suitability for outpatient hysteroscopy is not predictable based on parity of menopausal status. Women would elect to undergo outpatient hysteroscopy again if required and this is likely due to several reasons including convenience and lack of requirement for general anaesthetic.

Read Full Article HTML DOI: 10.29328/journal.cjog.1001076 Cite this Article Read Full Article PDF

References

  1. Clark TJ, Voit D, Gupta JK, Hyde C, Song F, et al. Accuracy of Hysteroscopy in the Diagnosis of Endometrial Cancer and Hyperplasia - A Systematic Quantitative Review. JAMA. 2002; 288: 1610-1621. PubMed: https://pubmed.ncbi.nlm.nih.gov/12350192/
  2. Royal College of Obstetricians and Gynaecologists. Green-top. Best Practice in Outpatient Hysteroscopy. Guideline No. 59. 2011.
  3. Clinical Practice Guideline: The Investigation and Management of Menorrhagia. Institute of Obstetricians and Gynaecologists, Royal College of Physicians of Ireland. Guideline No: 7. 2015.
  4. Kremer C, Duffy S, Moroney M. Patient satisfaction with outpatient hysteroscopy versus day case hysteroscopy: randomised controlled trial. BMJ. 2000; 320: 279-282. PubMed: https://pubmed.ncbi.nlm.nih.gov/10650023/
  5. van Dongen H, de Kroon CD, Jacobi CE, Trimbos JB, Jansen FW. Diagnostic hysteroscopy in abnormal uterine bleeding: a systematic review and meta-analysis. BJOG. 2007; 114: 664-675. PubMed: https://pubmed.ncbi.nlm.nih.gov/17516956/
  6. Litta P, Cosmi E, Saccardi C, Esposito C, Rui R, et al. Outpatient operative polypectomy using a 5 mm-hysteroscope without anaesthesia and/or analgesia: advantages and limits. Eur J Obstet Gynecol Reprod Biol. 2008; 139: 210-214. PubMed: https://pubmed.ncbi.nlm.nih.gov/18248873/
  7. Downes E, Al-Azzawi F. How well do perimenopausal patients accept outpatient hysteroscopy? Visual analogue scoring of acceptability and pain in 100 women. Eur J Obstet Gynecol Reprod Biol. 1993; 48: 37-41. PubMed: https://pubmed.ncbi.nlm.nih.gov/8449260/
  8. Morgan M, Dodds W, Wolfe C, Raju S. Women's views and experiences of outpatient hysteroscopy: implications for a patient-centered service. Nurs Health Sci. 2004; 6: 315-320. PubMed: https://pubmed.ncbi.nlm.nih.gov/15507052/

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