Improved patient compliance using pediatric cystoscope during office hysteroscopy.

OBJECTIVE

To evaluate the use of a pediatric cystoscope in office diagnostic hysteroscopy.

METHODS

Retrospective review (Canadian Task Force classification II-2).

METHODS

Maccabi Outpatient Women's Health Center.

METHODS

One thousand three hundred and thirty-five women; 959 (71.8%) premenopausal and 376 (28.2%) menopausal.

METHODS

Office diagnostic hysteroscopy using 2.3-mm diameter pediatric cystoscope, without premedication or anesthesia.

RESULTS

Hysteroscopy was successfully completed in 1298 patients (97.3%). The main reason for failure was cervical stenosis. Menopausal status was the only statistically significant factor correlating with increased failure rate. The analysis demonstrates that for every year of age, the OR for success decreases by 0.965, and success rises by 1.29 for every delivery the woman had. In menopausal women, the OR for success decreases by 0.45. Dilatation of the cervix was required in six women (0.46%), and local anesthesia was needed in only two women. One uterine perforation was recorded, and eight women (0.006%) developed vasovagal reflex or severe abdominal cramps. Post procedural oral analgesia was needed in 108 (8%) of the women.

CONCLUSIONS

The combination of a very small diameter continuous flow pediatric cystoscope, together with its ability to deliver high-quality images of the uterine cavity, make this instrument an excellent option for office diagnostic hysteroscopy.