Research Article| Volume 9, ISSUE 3, P158-162, September 1999

Establishing an outpatient hysteroscopy service

  • I.M. Symonds
    Correspondence to: J.W W S.
    Senior Lecturer in Obstetrics and Gynaecology, Academic Department of Obstetrics and Gynaecology, Clinical Sciences Building, Derby City General Hospital, Uttoxeter Road, Derby DE22 3NE, UK
    Search for articles by this author
      This paper is only available as a PDF. To read, Please Download here.


      Hysteroscopic examination of the endometrium can be carried out as an outpatient procedure with no loss in diagnostic accuracy and at considerably lower cost than when done as a day-case. Cervical dilation is required in less than 20% of cases and only one-third of patients require local anaesthetic. Over 90% of women find the procedure acceptable and report minimal discomfort. Approximately 50% of women will have some abnormality identified at hysteroscopy of whom 1–2% will have endometrial malignancy. Twenty per cent of patients require subsequent hysteroscopy surgery under general anaesthetic, mostly for the removal of benign lesions. The initial capital investment required to establish a new service is small when compared to the long-term savings on the cost per patient procedure.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Obstetrics, Gynaecology and Reproductive Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Golan A.
        • Eilat E.
        • Ron-El R.
        • Herman A.
        • Soffer Y.
        • Bukovsky I.
        Hysteroscopy is superior to hysterosalpingography in infertility investigation.
        Acta Obstet Gynecol Scan. 1996; 5: 654-656
        • Alcazar J.L.
        • Laparte C.
        Comparative study of transvaginal ultrasonography and hysteroscopy in postmenopausal bleeding.
        Gynecol Obstet Invest. 1996; 41: 47-49
        • Marty R.
        • de Brux J.
        Diagnostic evaluation of postmenopausal bleeding by fibrohysteroscopy.
        J Am Assoc Gynecol Laparosc. 1996; 3: S28-S29
        • Nagele F.
        • O'Connor H.
        • Davies A.
        • Badway A.
        • Mohamed H.
        • Magos A.
        2500 outpatient diagnostic hysteroscopies.
        Obstet Gynecol. 1996; 88: 87-92
        • Meyer L.
        • Moore J.
        • McMillan L.
        Outpatient hysteroscopy in the management of abnormal vaginal bleeding.
        J Am Assoc Gynecol Laparosc. 1996; 3: S30-S31
        • Cooper M.J.
        • Broadbent J.A.
        • Molnar B.G.
        • Richardson R.
        • Magos A.L.
        A series of 1000 consecutive out-patient diagnostic hysteroscopies.
        J Obstet Gynaecol. 1995; 21: 503-507
        • La Sala G.B.
        • Sacchetti F.
        • Dessanti L.
        • et al.
        Panoramic diagnostic microhysteroscopy: analysis of results obtained from 976 patients.
        Acta Europaea Fertilitatis. 1986; 17: 36-375
        • Nagele F.
        • Bournas N.
        • O'Connor G.
        • Broadbent M.
        • Richardson R.
        • Magos A.
        Comparison of carbon dioxide and normal saline for uterine distension in outpatient hysteroscopy.
        Fertil Steril. 1996; 65: 305-309
        • Blanc B.
        • D'Ercole C.
        • Cravello L.
        Indications for diagnostic hysteroscopy.
        Reprod Humaine et Hormones. 1996; 9: 558-560
        • Hidlebaugh D.
        A comparison of clinical outcomes and cost of office versus hospital hysteroscopy.
        J Am Assoc Gynecol Laparosc. 1996; 4: 39-45
        • Gaglione R.
        • Cinque B.
        • Paparatti L.
        • Pistilli E.
        Hysteroscopy: a milestone in gynaecology.
        Gynaecol Endoscopy. 1996; 5: 319-322
        • Vercellini P.
        The role of transvaginal ultrasonography and outpatient diagnostic hysteroscopy in the evaluation of patients with menorrhagia.
        Human Reprod. 1997; 12: 1768-1771
        • Nagele F.
        • Lockwood G.
        • Magos A.L.
        Randomised placebo controlled trial of mefenamic acid for premedication at outpatient hysteroscopy: a pilot study.
        Br J Obstet Gynaecol. 1997; 104: 842-844
        • Valli E.
        • Zupi E.
        • Marconi D.
        • Solima E.
        • Romanini C.
        Outpatient diagnostic hysteroscopy.
        J Am Assoc Gynecol Laparosc. 1998; 5: 397-402
        • Nagele F.
        • O'Connor H.
        • Baskett T.F.
        • Davies A.
        • Mohammed H.
        • Magos A.L.
        Hysteroscopy in women with abnormal uterine bleeding on hormone replacement therapy: a comparison with postmenopausal bleeding.
        Fert Steril. 1996; 65: 1145-1150
        • Hill N.C.W.
        • Broadbent J.A.M.
        • Magos A.L.
        • Baumann R.
        • Lockwood G.M.
        Local anaesthethesia and cervical dilation for outpatient diagnostic hysteroscopy.
        J Obstet Gynaecol. 1992; 12: 33-37
        • Clark S.
        • Vonau B.
        • Macdonald R.
        Topical anaesthesia in outpatient hysteroscopy.
        Gynaecol Endoscopy. 1996; 5: 141-144
        • Wieser F.
        • Kurz C.
        • Wenzl R.
        • Albrecht A.
        • Huber J.C.
        • Nagele F.
        Atraumatic cervical passage at outpatient hysteroscopy.
        Fertil Steril. 1998; 69: 549-551
        • Davies A.
        • Richardson R.E.
        • O'Connor Baskett T.F.
        • Nagele F.
        • Magos A.L.
        Lignocaine aerosol spray in outpatient hysteroscopy: a randomised double-blind placebo controlled trial.
        Fertil Steril. 1997; 67: 1019-1023
        • De Jong P.
        • Doel F.
        • Falconer A.
        Outpatient diagnostic hysteroscopy.
        Br J Obstet Gynaecol. 1990; 97: 299-303
        • Kremer C.
        • Barik S.
        • Duffy S.
        Flexible outpatient hysteroscopy without anaesthesia: a safe, successful and well-tolerated procedure.
        Br J Obstet Gynaecol. 1998; 105: 672-676
        • Bellingham F.R.
        Outpatient hysteroscopy — problems.
        Aust NZ J Obstet Gynaecol. 1997; 37: 202-205
        • Valli E.
        • Zupi E.
        • Marconi D.
        • Solima E.
        • Fabiani C.
        • Giovarruscio M.
        • Romanini C.
        Cost and benefits of office diagnostic hysteroscopy.
        J Am Assoc Gynecol Laparosc. 1996; 3: S52
        • Kremer C.
        • Arnott M.
        • Dufy S.
        A randomised controlled trial of outpatient hysteroscopy compared with day case hysteroscopy. Endoscopy surgery.
        in: Joint RCOG/BSGE meeting. 1998
        • Gillespie A.
        • Nichols A.
        The value of hysteroscopy.
        Aust NZ J Obstet Gynaecol. 1994; 34: 84-88