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Operative office hysteroscopy without anesthesia: analysis of 4863 cases performed with mechanical instruments.

STUDY OBJECTIVE: To evaluate the efficacy of, and patients' satisfaction with, office hysteroscopic treatment of benign intrauterine pathologies using 5F hysteroscopic instruments.

DESIGN: Observational clinical study (Canadian Task Force classification II).

SETTING: University center.

PATIENTS: Four thousand eight hundred sixty-three (4863) women.

INTERVENTION: Office hysteroscopy without analgesia or anesthesia.

MEASUREMENTS AND MAIN RESULTS: We used 5F mechanical instruments (scissors, grasping forceps) to treat cervical and endometrial polyps ranging between 0.2 and 3.7 cm, as well as intrauterine adhesions and anatomic impediments. From 71.9% to 93.5% of women underwent the procedure without discomfort for all pathologies treated except endometrial polyps larger than the internal cervical os, for which 63.6% experienced low or moderate pain. At 3-month follow-up, pathology persisted in 364 patients (5.6%).

CONCLUSION: Simple instruments enable us to perform many operative procedures in an office setting with excellent patient satisfaction, provided that the indications are correct.

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