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Flashcards in Procedures Deck (10)
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1
Q

What hysteroscope should be used in routine outpatient hysteroscopy?

A

miniature - 2.7mm with a 3-3.5mm sheath

2
Q

Comparison between CO2 and saline for distension in routine hysteroscopy

A

saline provides better view and quicker procedure than CO2 and is required as a conducting medium for bipolar electrosurgery, it is also associated with less vasovagal episodes
But neither are better at reducing pain

3
Q

What is the main use of routine hysteroscopy?

A

Assessment of abnormal uterine bleeding + assessment of infertility - can also be used for operative procedures including endometrial polypectomy/ablation/removal of subserosal fibroids and lost IUDs/cervical sterilisation

4
Q

What is the recovery of outpatient compared to day-case hysteroscopy?

A

mobilisation straight away vs 105 mins post op

recovery in 2 days vs 3 days post op

5
Q

What is the risk of uterine perforation during hysteroscopy?

A

up to 1.7%

6
Q

Analgesia pre hysteroscopy

A

avoid opiates, NSAIDs pre-op if suitable

7
Q

Risks of cervical dilatation

A

vasovagal episode, uterine trauma, pain - should not be performed routinely

8
Q

Benefit of local instillation of local anaesthesia to cervical canal in outpatient hysteroscopy (instillagel)

A

fewer vasovagal episodes but no pain reduction.

9
Q

What anaesthesia should be applied if a cervical tenaculum is used during outpatient hysteroscopy?

A

topical anaesthesia (instillagel) to the ectocervix

10
Q

When is intracervical or paracervical local anaesthesia advised in outpatient hysteoscopy

A

never routinely with minature hysteroscope

but if there is a requirement if hysteroscope is >5mm or there is cervical stenosis