This study evaluated an office hysteroscopy service with 700 annual cases. A retrospective review of 141 women undergoing NovaSure endometrial ablation from 2011-2015 found 79% did not require further treatment, while 21% received additional care including 10% who had a hysterectomy. A survey of 100 women in the office hysteroscopy service from 2015-2016 found high satisfaction, with 93 women scoring overall acceptability ≥8 and stating they would repeat the procedure. While 17 women reported severe pain during treatment, staff were found to be supportive and privacy was maintained.

1. Office operative hysteroscopy service: remarkable clinical success and
outstanding women satisfaction
Ayman Ewies, Consultant Gynaecologist; Verena Byrne, ST1 in O&G; Ihab Abbasi, ST7 in O&G
Sandwell and West Birmingham Hospitals (SWBH) NHS Trust, UK
Background
• Office operative hysteroscopy became the gold standard in
managing uterine cavity problems in the UK.
• One of the challenges that face such service is reducing pain
and anxiety, and maintaining optimal communication with
women to maximize satisfaction.
Objectives
• This pilot study was conducted to evaluate the contemporary
office hysteroscopy set up that was established in 2011 in
SWBH with workload of 700 cases per annum.
• We offer diagnostic as well as operative hysteroscopy
service using Myosure, Versapoint, Novasure, Thermachoice
and Thermablate technologies.
Design
This pilot study has 2 parts:
1. A retrospective review of electronic records of 141 women
underwent office NovaSure endometrial ablation from 1st
May 2011 to 31st October 2015 (follow-up period of 2-55
months).
2. A 10-itemed patient satisfaction questionnaire prospectively
handed to all women (n=100) attending the office
hysteroscopy service from 1st October 2015 to 31st January
2016. All questions were answered using visual analogue
scale (score 0-10).
Results
Part 1:
• The majority of women (n=112, 79%) undergoing NovaSure
ablation did not require any further treatment following the
procedure.
• Twenty nine women (21%) were re-referred to see a
gynaecologist with abnormal menstruation or
dysmennorhoea; 14 (10%) underwent hysterectomy and 15
were managed either conservatively of medically. Conclusion
• Real life experience (outside clinical trial setting) demonstrated
that Office Novasure ablation has high success rate in clinical
terms with subsequent decrease in theatre utilisation and bed
occupancy.
• Office operative hysteroscopy service is associated with high
satisfaction rate when the service is run by experienced staff
who provide good support and appropriate explanation to
women.
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0
10
20
30
40
50
60
70
80
90
0-3 4-7 8-10
Pain experienced during and after the procedure
During
After
[VALUE]
[VALUE]
[VALUE]
Follow up
No Follow up Medical or Conservative Hysterectomy
Part 2:
• 93 women recorded an overall acceptability
score of ≥8 stating they will have the same
procedure repeated if clinically needed in the
future, and 97 would recommend it to their
friends.
• All women affirmed that the staff were
welcoming and supportive, the procedure was
well explained and dignity was maintained
during the procedure (score = 9-10).
• Although 17 women described the pain
experienced during the procedure to be severe
(score ≥8), 15 stated that it settled immediately
after the procedure.
• All these women were either reported to be very
anxious prior to the procedure (score ≥8) or were
in the Novasure group