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RCOG publishes update to Green-top Guideline on Outpatient Hysteroscopy

9 Sept 2024

Today, the RCOG has published an updated version of the Green-top Guideline on Outpatient Hysteroscopy.

Hysteroscopy is a procedure that involves examining the inside of the uterus to help diagnose and treat gynaecological conditions. This update aims to support the provision of evidence-based, high quality care with particular reference to minimising pain and optimising the patient experience with outpatient hysteroscopy.

The updated guidance recommends women and people are provided with information about the procedure of outpatient hysteroscopy including the benefits and risks, possible pain relief options as well as alternative care settings, prior to their clinic appointment. It also states that women should be able to choose to reschedule an appointment, once they have received all of the information to allow more time for decision making. 

Additionally, since the last guideline was published, the scope has been widened to include information around effective pain relief options, informed consent, training, standards of care provision and clinical documentation. 

This guidance will supplement the already published Good Practice Paper, and will be followed by an updated patient information resource on this topic, providing a whole suite of guidance to ensure high quality service provision, as well as person-centred clinical care.

Dr Geeta Kumar, Consultant Gynaecologist and Vice President of the Royal College of Obstetricians and Gynaecologists, said:
“The College is committed to ensuring good quality care for everyone who is offered a hysteroscopy and is committed to promote high-quality clinical practice.
“As a College, we hear the concerns that are being raised by women and people who have had poor experiences of undergoing gynaecological procedures like hysteroscopy, particularly in outpatient settings. While some women experience minimal pain or discomfort, for others it can be an extremely painful procedure and the role of informed decision-making and consent is paramount. 
“Clear accurate written and verbal information must be provided, both at the time of referral, and at the procedure appointment. This will support a woman to make an informed choice, including whether they want to proceed with the procedure and if so, their preferences for treatment setting and pain relief options.”
Jane Plumb, Women’s Voices Lead, said:
“Women must be well-informed and supported in their healthcare decisions. Many may prefer outpatient hysteroscopy as it may mean quicker recovery and earlier appointments, but some may choose inpatient treatment. The decision should always be theirs, based on full information, including on potential pain levels and pain management options in each setting. They should also know they can stop the procedure if it becomes too much. All organisations that offer hysteroscopy should urgently implement this new guidance.”
  • You can access the guideline here.
  • You can view our other Green-top Guidelines here
  • Clinical and research
  • Gynaecology