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Office hysteroscopy: a valuable but under-utilized technique.
1Minimally Invasive Gynecological Surgery Unit, Newton Wellesley Hospital, Newton, Massachusetts 02462, USA. kisaacson@partners.org
Current Opinion in Obstetrics & Gynecology
|August 2, 2002
Summary
Gynecologists underutilize office hysteroscopy, a valuable diagnostic tool for intrauterine pathology. This review encourages wider adoption by addressing barriers like cost and expertise, improving patient care and avoiding invasive procedures.
Area of Science:
- Gynecology
- Minimally Invasive Procedures
Background:
- Office hysteroscopy has been available for over 30 years.
- Urologists widely use office cystoscopy (nearly 100%) for bladder pathology.
- Less than 20% of gynecologists utilize office hysteroscopy for intrauterine pathology.
Purpose of the Study:
- To remind gynecologists of office hysteroscopy indications.
- To provide an update on office hysteroscopy equipment, techniques, and reimbursement.
- To encourage wider adoption of office hysteroscopy in gynecological practice.
Main Methods:
- Review of existing literature and clinical practice.
- Analysis of potential barriers to office hysteroscopy utilization.
- Discussion of benefits compared to traditional procedures.
Main Results:
- Office hysteroscopy is underutilized by gynecologists compared to urologists' use of cystoscopy.
- Perceived barriers include lack of perceived patient benefit, high equipment costs, poor reimbursement, and lack of expertise.
- Underutilization denies patients a less invasive diagnostic technique.
Conclusions:
- Many women are denied the benefits of office hysteroscopy due to its underutilization.
- This can lead to more invasive procedures like diagnostic hysteroscopy and D&C under general anesthesia.
- Addressing misconceptions about cost, reimbursement, and expertise can increase the use of this valuable technology.