Abstract
Background: A retrospective study that analysed data for three consecutive years from the Hysteroscopy Clinic at the Department of Obstetrics and Gynecology, Valme University Hospital.
Objective: To analyse the data of lesions removed in the hysteroscopy clinic in comparison with those scheduled for the operating room to show that hysteroscopy could be a more effective procedure.
Methods: Patients undergoing operative hysteroscopy for various indications were included. The 5 mm Bettocchi hysteroscopes and the 5.8 mm Palex Mini-Resectoscope were used.
Results: A total of 1233 patients were seen in the hysteroscopy clinic between 2015 and 2017. In 2015, 344 hysteroscopies were performed, of which 57 (16.5%) were performed in the operating room. In 2016, 445 hysteroscopies were performed and 46 (10.3%) were scheduled in the operating room. During 2017, a total of 444 hysteroscopies were performed, of which only 6 (1.3%) were performed in the operating room (P < 0.001). Five large fibroids and one case of complex polyp were removed in the operating room in 2017. The mini-resector was used in 202 cases (45.4%). Paracervical local anaesthesia was given to 383 (86.2%) patients.
Conclusion: The data obtained in our study shows a significant reduction in the number of hysteroscopies scheduled for surgery in 2017 (1.3%) and, therefore, hysteroscopy has been shown to be a more effective procedure. This trend may be due to the introduction of the mini-resectoscope and the use of paracervical local anaesthesia.
Keywords: Clinical pathway, hysteroscopic surgery, office hysteroscopy, operative hysteroscopy, outpatient hysteroscopy, paracervical anaesthesia, submucosal myoma.
Graphical Abstract
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