Office operative hysteroscopy - an option to consider

Objective: To evaluate the feasibility and patient acceptability of office operative hysteroscopy. Study design/population/methods: A retrospective analysis of clinical files was performed in 387 consecutive patients submitted to office operative hysteroscopy for benign intrauterine pathology during 4 years. The following data was extracted: the procedures performed, technical feasibility of the procedures, need for local anaesthesia, complications that occurred, the pain level referred (in a scale of 0 to 10), and the influence of previous vaginal delivery or menopause on the experienced pain level. Results: Of the 2780 patients submitted to diagnostic hysteroscopy during the 4 year period, an office operative procedure was proposed and accepted by 387. The procedures performed were polypectomy (45.2%), destruction of intrauterine adhesions (44.2%), intrauterine device removal (6.9%), septotomy (2.8%) and myomectomy (0.8%). Local anaesthesia was required in 17.3% of cases, and its need was independent of the occurrence of previous vaginal deliveries or the menopause. No major complications occurred. Pain was registered by 71% of patients undergoing operative hysteroscopy, and the average level was 5.3, corresponding to moderate pain. The level of pain varied from 3.6 ±2.6 in IUD removal to 5.9 ±2.7 in intrauterine adhesions destruction. This aspect was also independent of previous vaginal deliveries and/or the menopause. Conclusions: Office operative hysteroscopy appears to be a feasible and safe procedure, which is reasonably well tolerated by patients. It is possible to perform these techniques without local anesthesia in the vast majority of cases, with only a moderate level of pain that is independent of the occurrence of previous vaginal deliveries or the menopause. Histeroscopia cirurgica de ambulatorio – uma opcao a