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Hysteroscopy in the Clinic: Application of Clinical Pathway

[ Vol. 16 , Issue. 1 ]

Author(s):

María Dolores Lara Domínguez*, Carlota García-Salmones González, Elena Mantrana Bermejo, Virginia Caballero Fernández and María Rosa Oña López   Pages 69 - 73 ( 5 )

Abstract:


Background: A retrospective study that analysed data for three consecutive years from the Hysteroscopy Clinic at the Department of Obstetrics and Gynecology, Valme University Hospital.

Objective: To analyse the data of lesions removed in the hysteroscopy clinic in comparison with those scheduled for the operating room to show that hysteroscopy could be a more effective procedure.

Methods: Patients undergoing operative hysteroscopy for various indications were included. The 5 mm Bettocchi hysteroscopes and the 5.8 mm Palex Mini-Resectoscope were used.

Results: A total of 1233 patients were seen in the hysteroscopy clinic between 2015 and 2017. In 2015, 344 hysteroscopies were performed, of which 57 (16.5%) were performed in the operating room. In 2016, 445 hysteroscopies were performed and 46 (10.3%) were scheduled in the operating room. During 2017, a total of 444 hysteroscopies were performed, of which only 6 (1.3%) were performed in the operating room (P < 0.001). Five large fibroids and one case of complex polyp were removed in the operating room in 2017. The mini-resector was used in 202 cases (45.4%). Paracervical local anaesthesia was given to 383 (86.2%) patients.

Conclusion: The data obtained in our study shows a significant reduction in the number of hysteroscopies scheduled for surgery in 2017 (1.3%) and, therefore, hysteroscopy has been shown to be a more effective procedure. This trend may be due to the introduction of the mini-resectoscope and the use of paracervical local anaesthesia.

Keywords:

Clinical pathway, hysteroscopic surgery, office hysteroscopy, operative hysteroscopy, outpatient hysteroscopy, paracervical anaesthesia, submucosal myoma.

Affiliation:

Doctor of Medicine and Surgery, Speciality in Gynaecology and Obstetrics, Gynecology Section, Hysteroscopy Department, Valme University Hospital, Seville, Doctor of Medicine and Surgery, Speciality in Gynaecology and Obstetrics, Gynecology Section, Hysteroscopy Department, Valme University Hospital, Seville, Doctor of Medicine and Surgery, Speciality in Gynaecology and Obstetrics, Gynecology Section, Hysteroscopy Department, Valme University Hospital, Seville, Doctor of Medicine and Surgery, Speciality in Gynaecology and Obstetrics, Gynecology Section, Hysteroscopy Department, Valme University Hospital, Seville, Doctor of Medicine and Surgery, Speciality in Gynaecology and Obstetrics, Gynecology Section, Hysteroscopy Department, Valme University Hospital, Seville

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