Hysteroscopy - 3 Years’ Experience at a Teaching Hospital

Abstract

Objective: To evaluate the indications, effectiveness and safety of hysteroscopy in Gynaecological surgery. Design, Duration and Place of study: A retrospective observational study from January 2003 to December 2005 at Fatima Memorial Hospital, Lahore. Patients and Methods: 76 patients who presented in the outpatient department of Gynae and Obstetrics at Fatima Memorial Hospital, Lahore with the following complaints including abnormal uterine bleeding, infertility, recurrent abortions and secondary amenorrhea were included in the study. They were re-operatively investigated and admitted a day prior to the surgery and discharged usually within 24 hours postoperatively. The subsequent follow-up was done in outpatient department. All the data was recorded arid then subsequently analyzed. Results: 76 patients were inducted in the study. Out of these 36 (47%) had infertility 20 (26.3%) had abnormal uterine bleeding, 8 patients (10.5%) had recurrent abortions, 8 (1 0.5%) presented with secondary amenorrhea, 3 patients (3.9%) presented with lost IUCD and one patient (1.3%) had follow-up hysteroscopy after resection of intra- uterine septum. Hysteroscopic findings revealed intra-uterine adhesions in 8 (10.5%), submucous fibroids in 15 (19.7%). endometrial polyp in 10 (13.1%) uterine septa in 8 (10.5%), atrophic endometrium in 9 (11.8%) while there was no abnormal finding in 26 (34.2%) patients. Two patients (0.6%) sustained uterine perforations, which were diagnosed and managed during operation but no other complication occurred. Conclusion: Hysteroscopy is an excellent tool to perform intra-uterine adhesiolysis, polypectomy, submucous myomectomy and endometrial ablation. In addition to being a quicker, less invasive and low risk procedure, it has got the advantage of being cheap with a shorter hospital stay and diminished recovery time. Hysteroscopy, both diagnostic and operative should be an integral part of gynaecological surgery in the teaching units.