Establishing a low-budget hysteroscopy unit in a resource-poor setting

Objective: To report our experience in establishing a low-budget hysteroscopy unit in the Niger Delta Region of Nigeria over a 7-year period. Materials and Methods: A retrospective descriptive study carried out between April 1, 2010, and March 31, 2017. Transaction receipts for the hysteroscopic equipment were retrieved. Situations where we had to improvise were documented. Patients' case files were retrieved, and relevant data were extracted. Results: A cart was made by a technician; home television sets served as monitors. A back-up, handheld LED light source was used. The hysteroscopic forceps and scissors were detachable versions. Sterile urine bags were improvised for providing larger saline infusions for bipolar resections. A total of 1002 hysteroscopic procedures were performed. Majority of the patients (979 or 97.70%) presented with infertility. The most common indication for hysteroscopy was intrauterine adhesions (401 or 40.01%). While 765 (76.35%) operative hysteroscopies were performed, 237 (23.65%) were diagnostic. The most common surgical procedure performed was intrauterine adhesiolysis (483 or 63.14%). There were 4 (0.40%) cases of inadvertent uterine perforation and one case (0.10%) of glycine distension fluid overload. Conclusion: Hysteroscopy with acceptable results is possible in a resource-poor setting using numerous innovative ways to circumvent the need for some of the expensive equipment.