Office hysteroscopy

Most operative office surgery can be done easily. If, midway through a procedure in the office, the operator finds that a myoma is too large or deep to resect safely in the office, the procedure can be terminated and rescheduled for the operating room. Polyps, retained products, and the lost intrauterine device all can be treated similarly. With the proper equipment and patient selection, the well-trained hysteroscopist can do extensive operative hysteroscopy in the office. With experience, the hysteroscopist can do diagnostic and operative hysteroscopy at the same time, resulting in a substantial savings of both cost and time for the patient and the physician. The future of office hysteroscopy may include endometrial ablation and transcervical sterilization, in addition to the procedures described in this chapter. Diagnostic hysteroscopy is becoming a standard part of office gynecology. With continued training, operative hysteroscopy will move into the realm of office gynecology at the same level as diagnostic hysteroscopy.