Main findings
A new OPH patient satisfaction survey (OPH-PSS) was developed in collaboration with the BSGE, with multi-disciplinary input and patient and public involvement (PPI). Women provided feedback and insight regarding their OPH journey leading to the development of a new standardised assessment tool suitable for benchmarking OPH services nationally. In two months, 5151 completed responses were received from 77 Units across the UK. This large return reflects the high prevalence of the procedure in contemporary gynaecological practice and infers the acceptability and utility of the developed survey tool. The majority of procedures were recorded as diagnostic. The survey was designed to assess all aspects of the patients OPH journey, including pre, peri and post-procedural experiences. The global rating of overall care was extremely high, with a mean score rating of 9.7 out of 10. Over 90% of women considered the OPH service they experienced as at least good, with over 80% considering the service excellent. Consistent with these findings, 90% agreed that they would choose the outpatient setting if the same situation arose again, with nearly 7 out of 10 women strongly agreeing. These findings suggest that for the vast majority of women, OPH is a safe, tolerable experience. This conclusion is further strengthened by the finding that overall, the mean pain score for OPH was less than the worst level of pain or discomfort experienced during a menstrual period.
The mean pain score for diagnostic hysteroscopy with or without endometrial biopsy was 5.2 / 10, and this intensity of pain was less than the worst pain experienced by women during their menstrual periods. It should be noted the most common operative procedure of polypectomy was not associated with greater pain than diagnostic procedures. Procedure specific data for other OPH procedures such as myomectomy and endometrial ablation were too limited to draw any conclusions. Whilst most women experienced pain, over half considered this to be slight. However, 15% of women reported feeling pain nearly all the time. Whilst women’s experience of OPH was variable, most did not experience substantial levels of pain, distress, anxiety, or embarrassment and felt in control. Vaso-vagal reactions from stimulation of the cervix are one of the most common side-effects of OPH 11, but 70% of respondents did not report feeling faint, and most women that did report this symptom felt the intensity as slight.
Before their consultation, the majority of women reported receiving written information in a clear and understandable format that included material about taking analgesia. These findings show that current patient information leaflets are fit for purpose. Standardised patient information leaflets (PILs) are available via the RCOG12 and newer alternative video-information resources are becoming available.13 It is important that such resources are updated regularly to reflect current guidance, which may change as more evidence becomes available.
Overall, almost all women felt that aspects of their consultation were dealt with appropriately. Communication seemed of a high standard, with most women reporting feeling at ease, with their concerns being addressed and staff treating them with respect and dignity. The vast majority of women had the opportunity to discuss pain relief and were given adequate post-procedural advice.