Out-Patient Diagnostic Hysteroscopy

Abstract

A prospective study of Diagnostic Hysteroscopy performed on day care basis in 100 consecutive women with abnormal uterine bleeding. To evaluate the suitability, efficacy and safety of Out Patient Diagnostic Hysteroscopy for investigation of abnormal uterine bleeding with special reference to need of anaesthesia. Procedure was done without anaesthesia in 77 cases while cervical block was required in 15 cases, Only 8 cases needed General anaesthesia 60 (60%) patients experienced minimal discomfort to mild pain. Only 3 patients experienced transient vasovagal attacks. No complications was related to the use general anaesthesia or cervical block uterine perforation occurred in one case. Hysteroscopic findings were normal ¡n almost half of the cases thus avoiding need for diagnostic curettage. Rest showed various kind of pathologies. Hysteroscopy was incomplete and inconclusive in 8 cases due to bleeding obscuring vision. No patient needed subsequent hospitalization. Subjective assessment of degree of pain experienced during Hysteroscopy was noted. Pulse and B.P. was monitored throughout the procedure. Hysteroscopic findings and its various complications were also noted. Diagnostic Hysteroscopy can be done on out- door basis with high acceptance rate in our patients. Anaesthesia can be used in cases of extreme anxiety, pain and cervical stenosis. In view of its safety, diagnostic accuracy and patient acceptability, introduction of out-door Diagnostic Hysteroscopy into more units should be encouraged It should be considered a procedure of choice for evaluation of cases of abnormal uterine bleeding as an adjunct to curettage.