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.