To audit our failure rates and reasons for the failure of outpatient Red flag hysteroscopy in our Unit

Introduction Outpatient hysteroscopy is an established diagnostic test and is in widespread use across the UK. The procedure involves the use of miniaturised endoscopic equipment to directly visualise and examine the uterine cavity, without the need for formal theatre facilities or general or regional anaesthesia. Outpatient hysteroscopy-Gold standard in diagnosing endometrial cancer with the sensitivity of around 86.2% and specificity of 99.2%. Material & Methods Retrospective review of the case records of the women who underwent hysteroscopy through Red Flag clinics. Total Number of fast track Diagnostic hysteroscopies were 60 and the number of treatment procedures in outpatient clinics was 13. A Proforma was designed to record details and data obtained were analysed using Microsoft Excel software. Results The result showed that postmenopausal bleeding (80%) was the most common indication for the referral to the Red flag hysteroscopy clinic followed by USS thick Endometrium (11.6%). 51% of the cases had BMI >30. Recommended vaginoscopy approach was used in 96% cases, cervical dilation was required in 10%. Documentation was considered standard in 100% of patients. The Correlation between histology and hysteroscopy findings was satisfactory with endometrial carcinoma (8%). The procedure was successful in 93.33% and only a small number 6% required further procedure. Conclusion Outpatient Procedure is Well tolerated, with Rapid Recovery and less waiting times. It helps in avoidance of unnecessary admissions, freeing up valuable theatre time, Less anaesthetic risk related to patients with high BMI. It gives Patient, Financial & Healthcare benefits, particularly in current COVID-19 Pandemic.