An Overview of Office Hysteroscopy

Office hysteroscopy (OH) is safe and effective for diagnosing and managing intrauterine pathology. Newer technology like smaller cameras, improved tissue removal devices, and recommendations for pain control now make OH comfortable for both the physician and patient, with OH having a very high level of patient satisfaction. Despite these benefits, OH remains significantly underutilized in the United States. This review aims to outline the current capabilities, technology, and patient and physician factors associated with successful OH. OH aids in the diagnosis of abnormal uterine bleeding, the most common reason for visits to the gynecologist, and can treat some causes in the same visit. Pathology most conducive to treatment with OH includes endometrial polyps, uterine septa, retained products of pregnancy, adhesions, and retained intrauterine devices (IUDs). When performing OH, equipment selection should be based on the type of procedure planned. Care should be taken to attempt to reduce pain and anxiety during OH, with recommended methods including preprocedural NSAIDs, vaginoscopy, and appropriate counseling and anxiety reduction. Appropriate patient selection is essential for both patient and physician comfort when performing OH. Further research and technology improvement can continue to increase comfort and performance in the office.