Office mini-hysteroscopy

The technique of diagnostic hysteroscopy has not get been accepted generall y as an ambulatory well-tolerated office procedure. Especially in the infer tile patient the standard hysteroscopic procedure is poorly tolerated in an office environment. Our prospective registration of 530 diagnostic office mini-hysteroscopies in infertile patients demonstrates that using an atraum atic insertion technique, watery distention medium and the new generation o f mini-hysteroscopic endoscopes, hysteroscopy can be performed in an office set-up without any form of anaesthesia and with a high patient compliance. The significant number of abnormal findings (28.5 %), the absence of compl ications and the low failure rate (2.3%) indicate that diagnostic office mi ni-hysteroscopy should be a first-line diagnostic procedure. Those results are compared with the registration of 4204 consecutive conventional diagnos tic hysteroscopies in a routine gynaecological population performed between 1982 and 1989, We conclude that the mini-hysteroscopic system offers a sim ple, safe and efficient diagnostic method in the office for the investigati on of abnormal uterine bleeding, to evaluate the cervix and uterine cavity in the infertile patient, for screening of endometrial changes in patients under hormone replacement therapy or anti-oestrogens as (adjuvant) treatmen t and, lastly, it may be very helpful for the interpretation of uncertain f indings in other diagnostic techniques such as ultrasound, magnetic resonan ce imaging, blind biopsy or hysterosalpingography.