Ambulatory hysteroscopy


Correspondence: T. Justin Clark. Email:


Key content

  • Routine diagnostic hysteroscopy under general anaesthesia is an anachronism.
  • Evidence-based RCOG guidance should be followed to ensure best practice in outpatient hysteroscopy.
  • The role of hysteroscopy in the diagnostic work-up of abnormal bleeding and reproduction remains unclear and further research is required to elucidate where it can be used most cost-effectively.

Learning objectives

  • A ‘no touch’ vaginoscopic technique should be employed routinely as this approach reduces pain during diagnostic rigid outpatient hysteroscopy and facilitates operative procedures by improving manipulation of miniature endoscopic equipment.
  • A contemporary outpatient hysteroscopy service should be able to provide surgical treatments for uterine polyps, small fibroids, lost coils, minor uterine anomalies, menstrual disorders and permanent contraception.

Ethical issues

  • Can we justify subjecting women, especially those with significant medical co-morbidities, to the risks and inconvenience of general anaesthesia for hysteroscopic procedures?