Outpatient hysteroscopy: the Calderdale and Huddersfield experience

Emmanuel Emovon, Archana Ranganathan, Sreelatha Tumula
Calderdale and Huddersfield NHS Trust, Halifax HX3 0PW, UK

Aim: To audit the outpatient hysteroscopy service at Calderdale and Huddersfield National Health Service Trust in order to improve our services.
Methodology: A retrospective audit of all patients referred for outpatient hysteroscopy from April 1, 2008, to June 30, 2008. Patients were identified using a patient administration system and endoscopy register. Analysis of the total number of patients referred, their indications, number of patients eventually referred for a general anesthesia procedure, patient-waiting times from referral, and therapeutic procedures carried out.
Results: A total of 234 patients were referred for outpatient hysteroscopy during the period of our study. Most of the patients were aged 40–49 years (63%), and majority of the referrals were for either postmenopausal bleeding (PMB) or intermenstrual/irregular bleeding. There were 97 referrals for PMB: 62 had successful outpatient hysteroscopy; 22 had ultrasound preprocedure, which showed thin endometrium, and therefore hysteroscopy was not carried out; and 13 patients deferred the procedure because of discomfort. In the intermenstrual/irregular bleeding group, hysteroscopy was successful in 94 of 105 patients. Approximately 91.2% of the patients were seen within 8 weeks from referral, and a total of 45 patients were referred for further procedure under general anesthesia.
Conclusion: Calderdale and Huddersfield National Health Service Trust has an effective diagnostic outpatient hysteroscopy service; however, there is a need to expand the service to reduce waiting times and incorporate therapeutic procedures into the service such as Versapoint polypectomy and endometrial ablation, which would in turn decrease the number of patients referred for hysteroscopy under general anesthesia.

Keywords: outpatient hysteroscopy, abnormal uterine bleeding, gynecology clinic