Update in Office Hysteroscopy

摘要

Learning Objectives: After participating in this CME activity, the obstetrician/gynecologist should be better able to: 1. Identify appropriate patients for hysteroscopy in the office setting. 2. Explain techniques used for office hysteroscopy, including patient preparation and pain control. 3. Review hysteroscopic procedures that are feasible and appropriate to perform in the office setting. Hysteroscopy is the gold standard for diagnosis and management of structural abnormalities of the endocervix, endo-metrial cavity, and tuba! ostia. The introduction of smaller caliber and flexible hysteroscopes, guidelines for patient selection, and options for pain management have increased the feasibility of this procedure in the office setting. The development of small (5 Fr) operative instruments has enabled the gynecologist to perform procedures in the office that are traditionally performed in the hospital. These include endometrial polypectomy, myomectomy, and endometrial resection. This article reviews indications for office hysteroscopy, selection of appropriate patients for the procedure, key aspects of technique, and diagnostic and operative considerations.