Summary
The aim of this guideline is to provide clinicians with up to date, evidence-based information regarding outpatient hysteroscopy, with particular reference to minimising pain and optimising the experience of the woman or person.
Outpatient hysteroscopy is an established, diagnostic and therapeutic procedure widely used across the UK. The procedure involves the use of miniaturised endoscopic equipment to directly visualise the uterine cavity, without the need for intravenous sedation or regional/general anaesthesia necessitating the use of formal theatre facilities. However, women or people should be made aware of other settings and modes of anaesthesia for hysteroscopy (e.g. procedure under general or regional anaesthesia, intravenous sedation) as an alternative to outpatient hysteroscopy. Outpatient hysteroscopy is indicated primarily in the assessment of women or people with a uterus with abnormal uterine bleeding but is also employed in the diagnostic work up of reproductive problems. Advances in endoscopic technology and ancillary instrumentation have facilitated the development of operative hysteroscopic procedures in an outpatient setting with or without the use of local anaesthesia.
Outpatient hysteroscopy, whether diagnostic or operative is successful, safe and well tolerated by most women. However, as with any procedure requiring instrumentation of the uterus, outpatient hysteroscopy can be associated with significant pain, anxiety and embarrassment. This not only impacts upon the satisfaction of women with their experience, but also limits the feasibility and possibly the safety, accuracy and effectiveness of the procedure. In order to minimise pain and discomfort, variations in hysteroscopic equipment, adaptations in technique and use of pharmacological agents have been advocated. This guideline assesses these components along with issues relating to optimal service provision.
Edition statement
This is the second edition of this guideline.
Developer declarations of interest
These are included in the published guideline.