Reliability of Office Hysteroscopic Reconstructive Surgery (HRS) in a Tertiary-Hospital Performing Conventional Day-Case HRS for 30 Years

Abstract

Objective:

This research was tested possible benefits of introducing office hysteroscopic reconstructive surgery (HRS) at a tertiary university hospital already performing conventional day-case (not requiring an overnight hospital stay) HRS for 30 years.

Materials and Methods:

The randomized controlled trial took place in the hospital's endoscopy unit and included women with recurrent pregnancy losses (RPLs), infertility, or hypomenorrhea, associated with morphologic abnormalities per transvaginal ultrasonography and confirmed by hysterosalpingography. The women were divided into group A (office HRS; n = 35) and group B (conventional day-case HRS; n = 35). All of these patients had hysteroscopic correction of their morphologic abnormalities.

Results:

Most patients were nulliparous (group A: 22, 62.9%; group B: 24, 68.6%). Salient complaints were RPL (group A: 17, 48.6%; group B: 16, 45.7%); infertility (group A: 13, 37%; group B: 15, 42.8%); and hypomenorrhea (group A: 5, 14.2%; group B: 4, 11.4%). Office HRS was successful in 24 patients (68.6%) with less operative time, less distension media, and shorter postoperative stays. Conventional day-case HRS was successful in all cases, with better visualization of the endometrial cavity and significantly better patient- and doctor-satisfaction.

Conclusions:

Day-case operative HRS is still a preferred approach due to successful access into the endometrial cavity with perfect visualization and high patient- and doctor-satisfaction rates, compared to office HRS. ClinicalTrials.gov ID: NCT03213639. (J GYNECOL SURG 38:57)