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Operative office hysteroscopy without anesthesia: analysis of 4863 cases performed with mechanical instruments
1Department of General and Specialist Surgical Sciences, Section of Obstetrics and Gynecology, University of Bari, Bari, Italy.
Study Objective:
To evaluate the efficacy of, and patients' satisfaction with, office hysteroscopic treatment of benign intrauterine pathologies using 5F hysteroscopic instruments.
Design:
Observational clinical study (Canadian Task Force classification II).
Setting:
University center.
Patients:
Four thousand eight hundred sixty-three (4863) women.
Intervention:
Office hysteroscopy without analgesia or anesthesia.
Measurements And Main Results:
We used 5F mechanical instruments (scissors, grasping forceps) to treat cervical and endometrial polyps ranging between 0.2 and 3.7 cm, as well as intrauterine adhesions and anatomic impediments. From 71.9% to 93.5% of women underwent the procedure without discomfort for all pathologies treated except endometrial polyps larger than the internal cervical os, for which 63.6% experienced low or moderate pain. At 3-month follow-up, pathology persisted in 364 patients (5.6%).
Conclusion:
Simple instruments enable us to perform many operative procedures in an office setting with excellent patient satisfaction, provided that the indications are correct.