Gynecology & Obstetrics
Open Access

Abstract

Factors Impacting the Success of Outpatient Hysteroscopy in the Rapid Access Clinic

Hooman Soleymani majd, Lamiese Ismail, Krishnayan Haldar and Vikram Singh Rai

Objective: Outpatient hysteroscopy (OPH) is increasingly used as the first line investigation for perimenopausal and postmenopausal women with abnormal uterine bleeding. With high success and good pathology detection rates it has the advantage of allowing investigation and management of patients within a one-stop clinic set-up, resulting in high patient acceptability. Failure rates are low, however the main limitation is patient intolerance secondary to pain. Difficulties are thought to be for encountered in nulliparous or postmenopausal women though the evidence is sparse. The aim of this study was to assess which patient factors have an impact on the success of OPH.
Design: Prospective observational study Material and methods: The study was carried out from September 2012 to March 2013 in the outpatient hysteroscopy clinic at John Radcliffe Hospital, Oxford. All 96 patients in this series had their OPH performed by the same operator, using only a complete vaginoscopic approach. We used binary logistic regression to analyse which factors had an effect.
Results: No significant correlation was found between age and menopausal status. Our study suggested that parity by itself is not predictive but it did find a statistically significant link between previous mode vaginal mode of delivery and successful OPH (p-value=0.001).
Conclusions: This paper enhances our understanding of relevant patient factors, which will be useful in facilitating more patient specific counselling. It should also ideally encourage further studies into strategies to improve the success rate of this invaluable diagnostic and therapeutic modality.