Office hysteroscopy: a valuable but under-utilized technique.
OBJECTIVE
The purpose of this review is to remind gynecologists of the indications for office hysteroscopy as well as to provide an update on equipment, techniques, and reimbursements.


RESULTS
Office hysteroscopy is a technique that has been available for over three decades. Whereas nearly 100% of urologists utilize office cystoscopy to evaluate bladder pathology, it is estimated that less than 20% of gynecologists utilize office hysteroscopy to evaluate intrauterine pathology. Although no one knows for sure, I speculate that the reasons for its under-utilization include a perceived lack of patients who would benefit from the procedure, expensive capital equipment with poor reimbursement, and a lack of expertise in performing the procedure.


CONCLUSIONS
As a result of not routinely using office hysteroscopy, many women who could greatly benefit from the use of the office hysteroscope are being denied a technique that is likely to keep them from more invasive and less useful procedures, such as diagnostic hysteroscopy and dilatation and curettage performed in the operating room under general anesthesia. This paper addresses these misconceptions in an effort to encourage more gynecologists to employ this technology.
Isaacson
Keith
K
Minimally Invasive Gynecological Surgery Unit, Newton Wellesley Hospital, Newton, Massachusetts 02462, USA. kisaacson@partners.org
D000556:Ambulatory Surgical Procedures / Q000191:economics / Q000295:instrumentation / Q000379:methods*; D003695:Delivery of Health Care; D016889:Endometrial Neoplasms / Q000175:diagnosis / Q000601:surgery; D005260:Female; D006761:Hospitals; D006801:Humans; D020702:Hysteroscopes / Q000191:economics; D015907:Hysteroscopy / Q000191:economics / Q000379:methods*; D007247:Infertility, Female / Q000209:etiology / Q000601:surgery; D007349:Insurance, Health, Reimbursement / Q000191:economics; D009367:Neoplasm Staging; D013525:Surgical Instruments / Q000191:economics; D014592:Uterine Hemorrhage / Q000209:etiology / Q000601:surgery