Ambulatory hysteroscopy and its role in the management of abnormal uterine bleeding

Abstract

Hysteroscopy is now an ambulatory procedure, having moved from a conventional day-case operating theatre environment to the outpatient clinic setting. Outpatient hysteroscopy can be used as a diagnostic test and as a therapeutic modality for women presenting with abnormal uterine bleeding. In many cases women can be diagnosed and treated efficiently during a single hospital appointment. This article reviews the development of ambulatory hysteroscopy and how it should optimally be performed and implemented. The contemporary role of this technology for investigating and treating women with abnormal uterine bleeding is then discussed.

Evaluation and ranking of different interventions for pain relief during outpatient hysteroscopy: A systematic review and network meta‐analysis

“…We included randomized controlled trials (RCT) that satisfied the following criteria: trials that included pre or postmenopausal women undergoing outpatient hysteroscopy (diagnostic or operative); studies that assessed the efficacy of different pharmacological (local anesthetics of different types and routes, misoprostol, NSAID, and opioids) and nonpharmacological interventions (pressure, stretch, heat, electricity, music and hypnosis) for pain relief during the procedure; and trials that had reliable data for extraction. We excluded trials that enrolled hospitalized patients undergoing hysteroscopy procedures, studies that compared different doses of the same intervention, and only abstracts available or conference proceedings (due to inability to perform thorough risk of bias assessment).…”

“…Outpatient hysteroscopy is a clinical procedure utilized for several diagnostic and therapeutic purposes . Diagnostic utilities include biopsy of the endometrium, identifying structural endometrial abnormalities, and the source of abnormal uterine bleeding . Therapeutic uses include endometrial polypectomy and removal of lost intrauterine devices .…”

Diagnostic yield and therapeutic outcome of hysteroscopy in women with infertility in a referral clinical setting: a Port Harcourt, Nigeria experience

“…The gynaecologic endoscopy practice of hysteroscopy is less intrusive, cost effective and often performed as day care surgery [ 8 ]. Ambulatory hysteroscopy is an out-patient -based hysteroscopy procedure, performed in an adapted hospital setting or a dedicated facility where, ideally, patient remains conscious and walks in and out of the unit without the need for prolonged post-operative recuperation or monitoring [ 9 ]. With advancement in technology hysteroscopic procedure are largely done without anaesthesia with the introduction of miniature scopes; hence outpatient office hysteroscopy.…”