title: Outpatient hysteroscopy: factors influencing post-procedure acceptability in patients attending a tertiary referral centre.
abstract: BACKGROUND
  Ambulatory hysteroscopy is a safe, reliable and cost-effective alternative to hysteroscopy under a general anaesthetic for the diagnosis of abnormal uterine bleeding.
  
  
  OBJECTIVE
  The objective of this study was to assess which factors influenced patients' willingness to attend for future outpatient hysteroscopy. The outpatient hysteroscopy service commenced at the Mercy Hospital for Women in 2000. It provides women with the opportunity to have the cause of abnormal uterine bleeding diagnosed in an outpatient setting.
  
  
  METHODS
  A prospective audit was conducted of 283 women attending for outpatient hysteroscopy at the Mercy Hospital for Women over a period of almost five years (May 2003 through February 2008).
  
  
  RESULTS
  Of the women audited, 88.7% stated that they would accept the procedure in future, whilst 11.3% would not. There was a significant difference between the two groups with respect to their median visual analogue pain scale (VAS) pain scores during the procedure (3.00 versus 6.50 P < 0.0001) with the higher score in the group who would not re-attend for the procedure. There was also a significant difference between the two groups with respect to the change in median VAS score from pain anticipated to pain experienced (0.00 versus 3.50 P = 0.0001). The rate of unsuccessful procedures was significantly higher (40.6% versus 0.8%P < 0.05) in future non-attendees as well as a higher rate of clinical vasovagal episodes (25% versus 5.2%P = 0.01) in women who stated that they would not re-attend for the procedure. Preprocedure analgesia and type of anaesthetic administered during the procedure did not seem to influence whether women would attend for outpatient hysteroscopy in future.
  
  
  CONCLUSIONS
  The acceptability rate for women attending for outpatient hysteroscopy during the audit period was 88.7%. Pain was a significant determinant of procedure acceptability; however, the acceptability rate was not influenced by analgesia or type of anaesthetic administered.
authors.affiliation: Department of Endosurgery, Mercy Hospital for Women, Heidelberg, Victoria, Australia. kmcilwaine@mercy.com.au
authors.forename: Kate
authors.initials: K
authors.lastname: McIlwaine
authors.forename: Emma
authors.initials: E
authors.lastname: Readman
authors.forename: Melissa
authors.initials: M
authors.lastname: Cameron
authors.forename: Peter
authors.initials: P
authors.lastname: Maher
mesh_terms: D000553:Ambulatory Care; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015907:Hysteroscopy / Q000009:adverse effects / Q000523:psychology; D008485:Medical Audit; D010146:Pain / Q000175:diagnosis / Q000209:etiology / Q000523:psychology; D010147:Pain Measurement; D010342:Patient Acceptance of Health Care; D011446:Prospective Studies; D012017:Referral and Consultation; D019462:Syncope, Vasovagal / Q000175:diagnosis / Q000209:etiology / Q000523:psychology; D016896:Treatment Outcome; D014592:Uterine Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*