Ambulatory Hysteroscopy - a New Trend in Diagnosticsand Treatment of Intrauterine Pathologies

Overview

Objective:
An analysis of ambulatory hysteroscopic procedures.Design: Retrospective study.Setting: Dept. of Obstetrics and Gynecology of the 1 st Faculty of Medicine, Charles University andthe General Faculty Hospital, Apolinářská 18, Prague 2, Czech Republic.Methods: The sample consists of 225 patients who underwent ambulatory hysteroscopy, duringthe period between September 1999 to February 2000. The sample makes up 46.3% of the totalnumber of hysteroscopies performed during that period. The procedures were performed undera paracervical block, only rarely in combination with analgesic sedation.Results: Indications for the procedure were most often abnormal uterine bleeding peri- or postme-nopausally, 51.2%, abnormal ultrasound findings in 9.8%, and endometrial polyps in 1.8%. In only23.11% of cases, hysteroscopy was performed in the frame of TCS (transcervical surgery), theremaining procedures were diagnostic. The paracervical block was a great benefit to the comfortof the ambulatory procedures. In 93%, the procedure was evaluated as comfortable, in 4.8% therewas discomfort, and in only 2.2% general anesthesia was used due to significant pain. We did notobserve any early or late complications.Conclusion: Hysteroscopy can be performed as an ambulatory procedure, assuming quality quip-ment, an experienced surgeon, and properly administered local anesthesia. Our results demon-strate that hysteroscopy is not only a diagnostic procedure, but can be used for certainprocedures in the area of TCS (with low or intermediate level of difficulty).

Key words:
hysteroscopy, paracervical anesthesia, transcervical surgery, hysterosonography