Outpatient diagnostic hysteroscopy

Study Objective. To evaluate the feasibility validity, indications, and res ults of a large series of diagnostic hysteroscopies performed without anest hesia. Design. Retrospective analysis of hysteroscopy charts performed between 198 9 and 1996 (Canadian Task Force classification II-2). Setting. University-affiliated endoscopy unit. Patients. Four thousand consecutive women referred for different indication s. Interventions. Diagnostic hysteroscopy was performed in 91% of patients wit hout premedication or anesthetics. In some women premedication or general o r local anesthesia was required to access the uterine cavity. Measurements and Main Results. The success rate, validity indication, compl ication rate, and number of biopsies were critically evaluated and assessed in relation to increased experience of operators. In 91% of women we acces sed the uterine cavity at the first attempt without premedication, whereas 207 (5.1%) patients required loca I anesthesia and 99 (2.4%) premedication. Only 1.6% required general anesthesia. In 52%;, intrauterine pathology was diagnosed and in 21% further surgical treatment was suggested. Conclusion. Hysteroscopy was feasible when performed in an outpatient setti ng without general or local anesthesia in more than 90%;, of women. The ope rator's experience seems a key factor both for accurate endometrial evaluat ion and to reduce failure and endometrial biopsy rates. The low frequency o f further surgical treatment justifies performing the procedure in the offi ce.