Diagnostic office hysteroscopy with the Storz TrophyScope® versus Cooper surgical Endosee®

BACKGROUND: Office hysteroscopy (OH) is becoming increasingly popular. Our objective was to determine the use patterns, reported pain scores, and success rates of OH with the 2.9 mm Storz TrophyScope (R) and handheld portable Cooper surgical Endosee (R) device in a clinic without previous office hysteroscopy experience. METHODS: A prospective cohort study of a hysteroscopy quality improvement database was conducted in a tertiary care center gynecology clinic. Patients undergoing OH with either the Storz TrophyScope (R) or Cooper Surgical Endosee (R) device were included. RESULTS: Of the 171 office hysteroscopies, 77 utilized the TrophyScopee, with 8 (10%) being inadequate, while 94 utilized Endosee (R), with 13 (14%) being inadequate (P=0.50). Of the 13 inadequate Endosee (R) hysteroscopies, 4 (31%) were due to visualization, 4 (31%) to patient intolerance, 3 (23%) to cervical stenosis, and 2 (15%) to a combination of these factors. Of the 8 inadequate TrophyScope (R) hysteroscopies, 7 (87%) were due to patient intolerance and 1 (13%) to cervical stenosis. Of the 150 adequate office procedures performed, 52 cases underwent subsequent procedures in the operating room (OR). Of these, 26 (84%) of 31 Endosee (R) cases and 18 (86%) of 21 TrophyScope (R) cases were in agreement with OR procedure findings. A subgroup analysis comparing mean pain levels did not significantly differ between the two hysteroscopes. CONCLUSIONS: There was no difference in accuracy with OR pathologic diagnoses, adequacy of procedure, and reported pain scores when comparing the TrophyScope (R) and Endosee (R) in this prospective cohort. Larger studies are needed to confirm the sensitivity, and specificity for these newer, disposable office hysteroscopic devices.