Skip to main content

Advertisement

SpringerLink
Log in

Office hysteroscopy: current trends and potential applications: a critical review

  • General Gynecology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Office hysteroscopy is an excellent method of identifying and treating intracavitary uterine lesions. It has become easy to learn and perform; as an aid of modern technological applications, it is safe, accurate, provides immediate results under direct visualisation, and offers the additional benefit of histological confirmation and the discomfort of patients is minimal. We applied an extended literature search to explore the special features and details of the technique itself, as it evolved since it first appeared 30 years back. Our initial goal was to examine potential changes/improvements of the modality, in terms of the instrumentation used and the technique itself, the indications of use, its incorporation in daily practice, and patients’ and clinicians’ acceptability.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Campo R, Molinas CR, Rombauts L et al (2005) Prospective multicentre randomized controlled trial to evaluate factors influencing the success rate of office diagnostic hysteroscopy. Hum Reprod 20:258–263

    Article  PubMed  Google Scholar 

  2. van Dongen H, de Kroon CD, Jacobi CE, Trimbos JB, Jansen FW (2007) Diagnostic hysteroscopy in abnormal uterine bleeding: a systematic review and meta-analysis. BJOG 114:664–675

    Article  PubMed  Google Scholar 

  3. Neuwirth RS (1978) A new technique for and additional experience with hysteroscopic resection of submucous fibroids. Am J Obstet Gynecol 131:91–94

    CAS  PubMed  Google Scholar 

  4. Bettocchi S, Selvaggi L (1997) A vaginoscopic approach to reduce the pain of office hysteroscopy. J Am Assoc Gynecol Laparosc 4:255–258

    Article  CAS  PubMed  Google Scholar 

  5. Bettocchi S, Ceci O, Di Venere R et al (2002) Advanced operative office hysteroscopy without anaesthesia: analysis of 501 cases treated with a 5 Fr. bipolar electrode. Hum Reprod 17:2435–2438

    Article  CAS  PubMed  Google Scholar 

  6. Bettocchi S, Ceci O, Nappi L et al (2004) Operative office hysteroscopy without anesthesia: analysis of 4,863 cases performed with mechanical instruments. J Am Assoc Gynecol Laparosc 11:59–61

    Article  CAS  PubMed  Google Scholar 

  7. Cicinelli E, Parisi C, Galantino P et al (2003) Reliability, feasibility, and safety of minihysterosocpy with a vaginoscopic approach: experience with 6,000 cases. Fertil Steril 80:199–202

    Article  PubMed  Google Scholar 

  8. De Angelis C, Santoro G, Re ME, Nofroni I (2003) Office hysteroscopy and compliance: mini-hysteroscopy versus traditional hysteroscopy in a randomized trial. Hum Reprod 18:2441–2445

    Article  PubMed  Google Scholar 

  9. Campo R, Van Belle Y, Rombauts L, Brosens I, Gordts S (1999) Office mini-hysteroscopy. Hum Reprod Update 5:73–81

    Article  CAS  PubMed  Google Scholar 

  10. Sharma M, Taylor A, di Spiezio Sardo A et al (2005) Outpatient hysteroscopy: traditional versus the ‘no-touch’ technique. BJOG 112:963–967

    Article  CAS  PubMed  Google Scholar 

  11. Garbin O, Kutnahorsky R, Göllner JL, Vayssiere C (2006) Vaginoscopic versus conventional approaches to outpatient diagnostic hysteroscopy: a two-centre randomized prospective study. Hum Reprod 21:2996–3000

    Article  CAS  PubMed  Google Scholar 

  12. Sagiv R, Sadan O, Boaz M et al (2006) A new approach to office hysteroscopy compared with traditional hysteroscopy: a randomized controlled trial. Obstet Gynecol 108:387–392

    PubMed  Google Scholar 

  13. Guida M, Di Spezio Sardo A, Acunzo G et al (2006) Vaginoscopic versus traditional office hysteroscopy: a randomized controlled study. Hum Reprod 21:3253–3257

    Article  CAS  PubMed  Google Scholar 

  14. Di Spiezio Sardo A, Taylor A, Tsirkas P et al (2008) Ηysteroscopy: a technique for all? Analysis of 5,000 outpatient hysteroscopies. Fertil Steril 89:438–443

    Article  PubMed  Google Scholar 

  15. Bettocchi S, Nappi L, Ceci O, Selvaggi L (2003) What does ‘diagnostic hysteroscopy’ mean today? The role of the new techniques. Curr Opin Obstet Gynecol 15:303–308

    Article  PubMed  Google Scholar 

  16. Fernandez H, Gervaise A, de Tayrac R (2000) Operative hysteroscopy for infertility using normal saline solution and a coaxial bipolar electrode: a pilot study. Hum Reprod 15:1773–1775

    Article  CAS  PubMed  Google Scholar 

  17. Garuti G, Cellani F, Colonnelli M, Grossi F, Luerti M (2004) Outpatient hysteroscopic polypectomy in 237 patients: feasibility of a one-stop “see-and-treat” procedure. J Am Assoc Gynecol Laparosc 11:500–504

    Article  PubMed  Google Scholar 

  18. Garuti G, Centinaio G, Luerti M (2008) Outpatient hysteroscopic polypectomy in postmenopausal women: a comparison between mechanical and electrosurgical resection. J Minim Invasive Gynecol 15:595–600

    Article  PubMed  Google Scholar 

  19. Bettocchi S, Nappi L, Ceci O et al (2005) Hysteroscopy and menopause: past and future. Curr Opin Obstet Gynecol 17:366–375

    Article  PubMed  Google Scholar 

  20. Wieser F, Kurz C, Wenzl R et al (1998) Atraumatic cervical passage at outpatient hysteroscopy. Fertil Steril 69:549–551

    Article  CAS  PubMed  Google Scholar 

  21. Zullo F, Pellicano M, Stigliano CM et al (1999) Topical anesthesia for office hysteroscopy. A prospective, randomized study comparing two modalities. J Reprod Med 44:865–869

    CAS  PubMed  Google Scholar 

  22. Sharma JB, Aruna J, Praveen Kumar et al (2009) Comparison of efficacy of oral drotaverine plus mefenamic acid with paracervical block and with intravenous sedation for pain relief during hysteroscopy and endometrial biopsy. Indian J Med Sci 63:244–252

  23. Floris S, Piras B, Orrù M et al (2007) Efficacy of intravenous tramadol treatment for reducing pain during office diagnostic hysteroscopy. Fertil Steril 87:147–151

    Article  CAS  PubMed  Google Scholar 

  24. Yang J, Vollenhoven B (2002) Pain control in outpatient hysteroscopy. Obstet Gynecol Surv 57:693–702

    Article  PubMed  Google Scholar 

  25. Rullo S, Sorrenti G, Marziali M et al (2005) Office hysteroscopy: comparison of 2.7- and 4-mm hysteroscopes for acceptability, feasibility and diagnostic accuracy. J Reprod Med 50:45–48

    PubMed  Google Scholar 

  26. Litta P, Cosmi E, Saccardi C et al (2008) Outpatient operative polypectomy using a 5 mm-hysteroscope without anaesthesia and/or analgesia: advantages and limits. Eur J Obstet Gynecol Reprod Biol 139:120–124

    Article  Google Scholar 

  27. Unfried G, Wieser F, lbrecht A, Kaider A, Nagele F (2001) Flexible versus rigid endoscopes for outpatient hysteroscopy: a prospective randomized clinical trial. Hum Reprod 16:168–171

    Article  CAS  PubMed  Google Scholar 

  28. Chang CC (2007) Efficacy of office diagnostic hysterofibroscopy. J Minim Invasive Gynecol 14:172–175

    Article  PubMed  Google Scholar 

  29. Jacobs VR, Paepke S, Schwarz-Boeger U et al (2005) Development of a thinner and more flexible type of minihysteroscope with a controlled 90-degree bendable tip for vision-guided endometrium biopsy. J Minim Invasive Gynecol 12:426–431

    Article  PubMed  Google Scholar 

  30. Papalampros P, Gambadauro P, Papadopoulos N et al (2009) The mini-resectoscope: a new instrument for office hysteroscopic surgery. Acta Obstet Gynecol Scand 88:227–230

    Article  PubMed  Google Scholar 

  31. Valle RF (1988) Future growth and development of hysteroscopy. Obstet Gynecol Clin North Am 15:111–126

    CAS  PubMed  Google Scholar 

  32. Di Spiezio Sardo A, Mazzon I, Bramante S et al (2008) Hysteroscopic myomectomy: a comprehensive review of surgical techniques. Hum Reprod Update 14:101–119

    Article  PubMed  Google Scholar 

  33. Bettocchi S, Di Venere R, Pansini N et al (2002) Endometrial biopsies using small-diameter hysteroscopes and 5F instruments: how can we obtain enough material for a correct histologic diagnosis? J Am Assoc Gynecol Laparosc 9:290–292

    Article  CAS  PubMed  Google Scholar 

  34. Nagele F, Bournas N, O’Connor H et al (1996) Comparison of carbon dioxide and normal saline for uterine distension in outpatient hysteroscopy. Fertil Steril 65:305–309

    CAS  PubMed  Google Scholar 

  35. Perez-Medina T, Bajo JM, Martinez-Cortes L, Castellanos P, Perez de Avila I (2000) Six thousand office diagnostic-operative hysteroscopies. Int J Gynaecol Obstet 71:33–38

    Article  CAS  PubMed  Google Scholar 

  36. Solima E, Brusati V, Ditto A et al (2008) Hysteroscopy in endometrial cancer: new methods to evaluate transtubal leakage of saline distension medium. Am J Obstet Gynecol 198:214

    Article  PubMed  Google Scholar 

  37. Lavie O, Gemer O, Ben-Arie A (2008) Office hysteroscopy and the risk of microscopic extrauterine spread in endometrial cancer. Gynecol Oncol 110:266–267

    Article  PubMed  Google Scholar 

  38. Colacurci N, De Franciscis P, Mollo A et al (2007) Small-diameter hysteroscopy with Versapoint versus resectoscopy with a unipolar knife for the treatment of septate uterus: a prospective randomized study. J Minim Invasive Gynecol 14:622–627

    Article  PubMed  Google Scholar 

  39. Garuti G, Luerti M (2009) Hysteroscopic bipolar surgery: a valuable progress or a technique under investigation? Curr Opin Obstet Gynecol 21:329–334

    Article  PubMed  Google Scholar 

  40. Isaacson K (2002) Office hysteroscopy: a valuable but under-utilized technique. Curr Opin Obstet Gynecol 14:381–385

    Article  PubMed  Google Scholar 

  41. Jansen FW, Vredevoogd CB, van Ulzen K et al (2000) Complications of hysteroscopy: a prospective, multicenter study. Obstet Gynecol 96:266–270

    Article  CAS  PubMed  Google Scholar 

  42. Hamou J, Salat-Baroux J, Siegler AM (1983) Diagnosis and treatment of intrauterine adhesions by microhysteroscopy. Fertil Steril 39:321–326

    CAS  PubMed  Google Scholar 

  43. Campo V, Campo S (2007) Hysteroscopy requirements and complications. Minerva Ginecol 59:451–457

    CAS  PubMed  Google Scholar 

  44. Gordts S, Campo R, Rombauts L, Brosens I (1998) Transvaginal salpingoscopy: an office procedure for infertility investigation. Fertil Steril 70:523–526

    Article  CAS  PubMed  Google Scholar 

  45. Di Spiezio Sardo A, Guida M, Bettocchi S et al (2008) Role of hysteroscopy in evaluating chronic pelvic pain. Fertil Steril 90:1191–1196

    Article  PubMed  Google Scholar 

  46. Molinas CR, Campo R (2006) Office hysteroscopy and adenomyosis. Best Pract Res Clin Obstet Gynaecol 20:557–567

    Article  PubMed  Google Scholar 

  47. Arjona JE, Miño M, Cordón J et al (2008) Satisfaction and tolerance with office hysteroscopic tubal sterilization. Fertil Steril 90:1182–1186

    Article  PubMed  Google Scholar 

  48. Glasser MH (2009) Practical tips for office hysteroscopy and second-generation “global” endometrial ablation. J Minim Invasive Gynecol 16:384–399

    Article  PubMed  Google Scholar 

  49. Pontrelli G, Landi S, Siristatidis C et al (2007) Endometrial vaporization of the cervical stump employing an office hysteroscope and bipolar technology. J Minim Invasive Gynecol 14:767–769

    Article  PubMed  Google Scholar 

  50. Jiménez JS, Gonzalez C, Alvarez C et al (2009) Conservative management of retained trophoblastic tissue and placental polyp with diagnostic ambulatory hysteroscopy. Eur J Obstet Gynecol Reprod Biol 145:89–92

    Article  PubMed  Google Scholar 

  51. Di Spiezio Sardo A, Di Carlo C, Salerno MC et al (2007) Use of office hysteroscopy to empty a very large hematometra in a young virgin patient with mosaic Turner’s syndrome. Fertil Steril 87:417

    PubMed  Google Scholar 

  52. Garuti G, Cellani F, Grossi F et al (2002) Saline infusion sonography and office hysteroscopy to assess endometrial morbidity associated with tamoxifen intake. Gynecol Oncol 86:323–329

    Article  PubMed  Google Scholar 

  53. Arslan S, Aytan H, Gunyeli I et al (2005) Office hysteroscopic evaluation of endometrium: can we hit the target? Arch Gynecol Obstet 271:200–202

    Article  PubMed  Google Scholar 

  54. Avila ML, Ruiz R, Cortaberria JR, Rivero B, Ugalde FJ (2008) Assessment of cervical involvement in endometrial carcinoma by hysteroscopy and directed biopsy. Int J Gynecol Cancer 18:128–131

    Article  CAS  PubMed  Google Scholar 

  55. Di Spiezio Sardo A, Mazzon I, Gargano V et al (2008) Hysteroscopic treatment of atypical polypoid adenomyoma diagnosed incidentally in a young infertile woman. Fertil Steril 89:456

    PubMed  Google Scholar 

  56. Lécuru F, Le Frère Belda MA, Bats AS et al (2008) Performance of office hysteroscopy and endometrial biopsy for detecting endometrial disease in women at risk of human non-polyposis colon cancer: a prospective study. Int J Gynecol Cancer 18:1326–1331

    Article  PubMed  Google Scholar 

  57. Hinckley MD, Milki AA (2004) 1,000 office-based hysteroscopies prior to in vitro fertilization: feasibility and findings. JSLS 8:103–107

    PubMed  Google Scholar 

  58. Lorusso F, Ceci O, Bettocchi S et al (2008) Office hysteroscopy in an in vitro fertilization program. Gynecol Endocrinol 24:465–469

    Article  PubMed  Google Scholar 

  59. El-Toukhy T, Sunkara SK, Coomarasamy A, Grace J, Khalaf Y (2008) Outpatient hysteroscopy and subsequent IVF cycle outcome: a systematic review and meta-analysis. Reprod Biomed Online 16:712–719

    Article  PubMed  Google Scholar 

  60. de Sá Rosa e de Silva AC, Rosa e Silva JC, Cândido dos Reis FJ, Nogueira AA, Ferriani RA (2005) Routine office hysteroscopy in the investigation of infertile couples before assisted reproduction. J Reprod Med 50:501–506

    Google Scholar 

  61. Bosteels J, Weyers S, Puttemans P (2010) The effectiveness of hysteroscopy in improving pregnancy rates in subfertile women without other gynaecological symptoms: a systematic review. Hum Reprod Update 16:1–11

    Article  PubMed  Google Scholar 

  62. Lasmar RB, Barrozo PR, de Oliveira MA, Coutinho ES, Dias R (2006) Validation of hysteroscopic view in cases of endometrial hyperplasia and cancer in patients with abnormal uterine bleeding. J Minim Invasive Gynecol 13:409–412

    Article  PubMed  Google Scholar 

  63. Brooks PG (2007) Is the management of abnormal uterine bleeding, is office hysteroscopy preferable to sonography? The case for hysteroscopy. J Minim Invasive Gynecol 14:12–14

    Article  PubMed  Google Scholar 

  64. Ceci O, Bettocchi S, Pellegrino A et al (2002) Comparison of hysteroscopic and hysterectomy findings for assessing the diagnostic accuracy of office hysteroscopy. Fertil Steril 78:628–631

    Article  PubMed  Google Scholar 

Download references

Conflict of interest statement

None.

Author information

Authors and Affiliations

  1. 36 Imathias str., Thrakomakedones, 13676, Athens, Greece

    Charalambos Siristatidis

  2. Third Department of Obstetrics and Gynaecology, “Attikon” Hospital, University of Athens Medical School, Rimini 1 str., Chaidari, 12462, Athens, Greece

    Charalambos Chrelias, George Salamalekis & Dimitrios Kassanos

Authors
  1. Charalambos Siristatidis
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Charalambos Chrelias
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. George Salamalekis
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Dimitrios Kassanos
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Charalambos Siristatidis.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Siristatidis, C., Chrelias, C., Salamalekis, G. et al. Office hysteroscopy: current trends and potential applications: a critical review. Arch Gynecol Obstet 282, 383–388 (2010). https://doi.org/10.1007/s00404-010-1437-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-010-1437-x

Keywords

Search

Navigation