Operative hysteroscopy in the outpatient setting: its role within a gynaecology service

A rapid-access gynaecology service was launched at Chelsea and Westminster Hospital in January 2003, offering, among else, trans-vaginal ultrasound and outpatient hysteroscopy on a see-and-treat basis. Our aim was to review the performance of this new service in its first year. Furthermore, to critically discuss the role of such clinics within gynaecology. Prospective collection of data of the new service for the first 12 months was conducted. One hundred and one patients were seen. Hysteroscopy was attempted in 107 patients and was carried out successfully in 103 of them (96%). In four patients, hysteroscopy was attempted but was not possible. Polyps were found in 35 patients and removed in 29 (83%). The remaining six patients did not seem suitable for outpatient removal. Overall, only 10% of the patients who were seen in the clinic eventually required a general anaesthetic. Of the patients who were referred from general practitioners, 56% were discharged after assessment and treatment and 44% had follow-up appointments organised within our hospital. The outpatient hysteroscopy service is effective and potentially frees up important hospital resources, both in outpatient clinics and operating theatres.