A Retrospective Analysis of 4800 Office Hysteroscopies at a Single Center

Abstract

Objective: Evaluation of the viability of office hysteroscopy in an Indian context at a single center. To encourage budding gynecologists to perform office hysteroscopy, which is possible with successful results with the correct strategy, method, and setting. Methods: Observational analysis in retrospect. Between January 2011 and January 2022, 4827 women had office hysteroscopy at our center. Around 1627 instances of office hysteroscopy with a Bettocchi 2.9 scope and a Hamou endomat were performed from 2011 to 2022 and 3200 hysteroscopies with Bettocchi 1.9 scope and Endometrial automatic suction irrigation system (EASI) (2011)(2012)(2013)(2014)(2015)(2016)(2017)(2018)(2019)(2020)(2021)(2022). The distension media utilized was regular saline. Hamou endomat parameters included a 200 ml/min drip rate, a 75-mm Hg irrigation pressure, and a 0.15 suction bar. Bettocchi 4 (1.9 mm) and Bettocchi 5 (2.9 mm) scope settings with EASI were 45 mm Hg. An experienced operator with office hysteroscopy training performed the hysteroscopy. Every operation was performed during the early proliferative period (4th-11th day). Key outcome measurements were complications, success and failure rates. Results: In roughly 4821 of instances, hysteroscopies were successful; however, 35 patients had pathology that required a two-step treatment. The majority of the hysteroscopies (2470; 51.2%) were diagnostic ones, while the remaining (2357; 48.83 %) were surgical ones. A vasovagal attack affected just two patients (2 of 4827). Conclusion: Together with reduced pressure, continuous flow irrigation, and vaginoscopic technique, advising the patient for ambulatory hysteroscopy played a crucial role in the outpatient environment in helping the patient deal with discomfort and anxiety. This method is made easier by recent developments in technique and apparatus, which may stimulate a wider acceptance by the gynecological community.