Use of hysteroscopy at the office in gynaecological practice

: Bevezetes: Az office hiszteroszkopia a mehűri vizsgalatot gyorsabba teszi, alacsonyabb koltsegigenyű, a betegek szamara pedig kevesebb megterhelessel jar. Celkitűzes: A szerző celja volt a vizsgalatok kozben tapasztalt fajdalomerzetek elemzese, uj eljaras kidolgozasa a petevezető-atjarhatosag ambulans vizsgalatara. Modszer: A vizsgalatok a Debreceni Egyetem, Szuleszeti es Nőgyogyaszati Klinikajan tortentek, ambulans korulmenyek kozott, anesztezia nelkul. A 400 vizsgalat eredmenyenek elemzese a hagyomanyos modszernel ismert javallatok alapjan keszult. A szerző a vizsgalatokhoz 2,7 mm atmerőjű optikat hasznalt diagnosztikus, illetve operativ huvellyel, es a fajdalomerzet objektivizalasara 70 betegnel VAS-t alkalmazott. A petevezető-atjarhatosagi vizsgalat soran 70 esetben hasonlitotta az uj modszert a laparoszkopos valtozathoz. Eredmenyek: Az office hiszteroszkopia alkalmazhato ambulans korulmenyek kozott, anesztezia nelkul. A tapasztalt fajdalomertekek az alcsoportokban (nem szult, szult, posztmenopauza, diagnosztikus/operativ alcsoport) szignifikansan nem kulonboztek, atlagertekuk 3,5±1,01 volt (p=0,34). A szelektiv pertubacio a laparoszkopos kromohidrotubaciohoz viszonyitva 92,06% pontossagunak bizonyult. Kovetkeztetesek: Az office hiszteroszkopia gyorsasaga, fajdalommentessege az uj eljaras szeles korű alkalmazasat tamasztja ala. Meddősegi kivizsgalasban kivalthatja a műtői korulmenyeket igenylő beavatkozasokat. Orv. Hetil., 2014, 155(40), 1589–1597. AIM: The aim of this work was to get familiar with the novel method. The author examined the level of pain during hysteroscopy performed for different indications with different types of instruments. In addition, the novel method invented for evaluating tubal patency was compared to the gold standard laparoscopy in 70 tubes. METHOD: Office hysteroscopy was performed in 400 cases for indications according to the traditional method. All examinations were performed in University of Debrecen, Department of Obstetrics and Gynecology in an outpatient setting. A 2.7 mm diameter optic with diagnostic or operative sheet was used. Hysteroscopies were scheduled between the 4th and 11th cycle day. For recording pain level VAS was used in 70 cases. Comparison of hysteroscopic evaluation of tubal patency to the laparoscopic method was studies in 70 cases. RESULTS: It was found that office hysteroscopy can be performed in an outpatient setting, without anesthesia. Pain level showed no difference among subgroups (nulliparous, non-nulliparous, postmenopausal, diagnostic, operative) (mean±SD, 3.5±1.01; p=0.34). For the evaluation of tubal patency, office hysteroscopy showed 92.06% accuracy when compared to laparoscopy. CONCLUSIONS: Office hysteroscopy has several advantages over traditional method. This procedure is fast, it has less strain for the patient. The novel method, rather than traditional hysteroscopy, should be used in the work-up of infertility as well.