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.