J W Ross1. 1. Center for Reproductive Medicine and Laparoscopic Surgery, 400 East Romie Lane, Salinas, CA 93901, USA.
Abstract
STUDY OBJECTIVE: To evaluate the feasibility of diagnostic office flexible minihysteroscopy for general gynecology, infertility, oncology, and urogynecology examinations. DESIGN: Prospective cohort analysis (Canadian Task Force classification II-2). SETTING: Private clinic. PATIENTS: Five hundred thirty-eight women. INTERVENTION: Diagnostic hysteroscopy or cystourethroscopy. MEASUREMENTS AND MAIN RESULTS: Office flexible minihysteroscopes 2.5 and 3.5 mm were successfully used in 384 patients to evaluate abnormal and postmenopausal bleeding, intrauterine device location, secondary amenorrhea, severe dysmenorrhea, infertility, tubal patency, and selective tubal insemination. Of these, 382 women (99.5%) were examined without local anesthesia or cervical dilatation. Biopsies with 3F instruments and tubal cannulations were performed without difficulty where indicated. In 225 patients, flexible minihysteroscopes were used to evaluate the genitourinary tract for symptoms of urethritis, interstitial cystitis, and urinary incontinence. Dynamic cystourethroscopy was done to examine the integrity of the bladder neck with hold command, cough, and maximum Valsalva maneuver. There were no unsuccessful hysteroscopic or cystoscopic examinations. CONCLUSION: Flexible minihysteroscopes can be successfully used in an office setting for both gynecologyic and urogynecologyic indications with high patient acceptance. The procedure is rapid and saves physician time.
STUDY OBJECTIVE: To evaluate the feasibility of diagnostic office flexible minihysteroscopy for general gynecology, infertility, oncology, and urogynecology examinations. DESIGN: Prospective cohort analysis (Canadian Task Force classification II-2). SETTING: Private clinic. PATIENTS: Five hundred thirty-eight women. INTERVENTION: Diagnostic hysteroscopy or cystourethroscopy. MEASUREMENTS AND MAIN RESULTS: Office flexible minihysteroscopes 2.5 and 3.5 mm were successfully used in 384 patients to evaluate abnormal and postmenopausal bleeding, intrauterine device location, secondary amenorrhea, severe dysmenorrhea, infertility, tubal patency, and selective tubal insemination. Of these, 382 women (99.5%) were examined without local anesthesia or cervical dilatation. Biopsies with 3F instruments and tubal cannulations were performed without difficulty where indicated. In 225 patients, flexible minihysteroscopes were used to evaluate the genitourinary tract for symptoms of urethritis, interstitial cystitis, and urinary incontinence. Dynamic cystourethroscopy was done to examine the integrity of the bladder neck with hold command, cough, and maximum Valsalva maneuver. There were no unsuccessful hysteroscopic or cystoscopic examinations. CONCLUSION: Flexible minihysteroscopes can be successfully used in an office setting for both gynecologyic and urogynecologyic indications with high patient acceptance. The procedure is rapid and saves physician time.