[The 3mm optical system in hysteroscopy]

To evaluate our first experience with 3 mm hysteroscope.

Prospective study.

Department of Obstetrics and Gynecology, 1st medical Faculty, Charles University, Prague.

105 hysteroscopic procedures in normal saline as distension fluid were performed between June and November 2001. We performed 60 (57.1%) diagnostic procedures and 45 (42.9%) minor surgical intrauterine interventions (mainly endometrial polyp < 2 cm resection). We used Versascope (Gynecare, Johnson & Johnson) 1.9 mm optics with 3.2 mm expandable operative sheath. All diagnostic procedures were done by minimal invasive way--using vaginoscopic approach. Main part of procedures were performed without any anaesthesia. In case of operative intervention we used Versapoint bipolar electrodes in normal saline and active outflow.

The surgeon evaluated the intrauterine findings and the patient evaluated subjective comfort during the procedure (comfortable, uncomfortable, painful). No complications were registered during or post procedure. 83 (73%) women undergone diagnostic procedure described the procedure without discomfort, 22 (21%) women described a moderate discomfort with pressure in the lower abdomen (all undergone intrauterine surgical intervention). No patient described severe discomfort or wish to have general anesthesia.

Miniaturized optical systems allows us to perform most cases of diagnostic and surgical intrauterine interventions (after proper patient selection) in an outpatient or office setting.