Introduction
Outpatient hysteroscopy (OPH) is the cornerstone of modern-day ambulatory gynaecological surgery. 1Hysteroscopy is the gold standard test to diagnose endometrial and structural uterine cavity pathologies associated with abnormal uterine bleeding (AUB) and reproductive failure. Furthermore, newer miniature technologies, have facilitated operative OPH, where many common uterine treatments can be conducted in the outpatient setting at the time of diagnosis; so-called ”see and treat” practice; expanded to include procedures such as endometrial ablation, polypectomy and myomectomy.2
The safety, convenience and efficiency of this common ambulatory procedure is well recognised.2-4 However, as outpatient hysteroscopy is performed in conscious patients, the pain and acceptability of OPH has been thoroughly investigated and reported using a variety of measures such as pain scores and bespoke, qualitative questionnaires. 5-8
A recent national survey of OPH practice in the United Kingdom highlighted several variations in OPH practice thereby raising questions about women’s experience of OPH.9 In this survey of 142 clinicians performing OPH, 85% of respondents reported routinely collecting patient feedback. However, 52% of these respondents reported using the NHS “Friends and family test”, a measure that is inherently non-specific to OPH. The survey also demonstrated that there was a lack of standardisation in the assessment of the patient experience of OPH.
The lack of a uniformly accepted OPH tool to assess patient’s experience of OPH precludes valid assessment of this common procedure, especially the comparative effectiveness of interventions such as surgical techniques, health technologies, and pharmacological agents in reducing pain and optimising patient experience. Moreover, there have been concerns expressed from patient groups about the variation in the quality of OPH service delivery and women experiencing unacceptable pain during OPH with long-term consequences.10
We, therefore, developed a questionnaire to evaluate the patient’s views and experience of OPH. Furthermore, we disseminated this tool across the UK to assess women’s perspective of their experiences of the OPH and to generate data to benchmark OPH practice with the ultimate aim of improving OPH services and optimising the patient experience.