Hysteroscopy is a commonly performed procedure today often used for assisting in the diagnosis and management of abnormal menstrual bleeding including unexplained post-menopausal bleeding.
In nearly all communities hysteroscopy is performed either in an office, an ambulatory surgery center or a hospital.
At the Center for Menstrual Disorders we perform hysteroscopy in an office-based setting while providing excellent pain control, in a familiar environment at low cost to you and your insurer. We offer a highly experienced and skilled staff who’ve worked together for many years with proven equipment that is often unavailable even at the most well-known and respected medical centers.
1. Pain control
Hysteroscopy is a safe procedure but it is not painless. In a study by Bradley and Widrich (1) the authors studied 417 women who were referred for hysteroscopy in an office setting. The patients described the pain they experienced as follows:
| Pain at Hysteroscopy | Percentage |
|---|---|
| Easily acceptable | 34.5 % |
| Acceptable discomfort | 22.2% |
| Tolerable discomfort | 27.4% |
| Barely tolerable | 12.4% |
| Intolerable | 3.4% |
From my standpoint that means at least 15.8% (the sum of the last two groups) found office hysteroscopy to be either intolerable or barely tolerable while another 27.4% found it to be uncomfortable but “tolerable”.
Some women might find this acceptable but I personally do not. I believe that patients should not have “barely tolerable” or “intolerable” procedures. This is neither good for patients nor their physicians. Women will suffer two-fold. First, they had a bad experience and second, the information that they were supposed to get may be unreliable or not obtainable at all. Importantly, the physician does not benefit from these scenarios as she or he is rushing to get through procedure and not cause you further pain.
For this reason many physicians offer diagnostic hysteroscopy in an operating room or ambulatory surgery center (ASC). While this solves the issue of pain there are numerous other issues one must consider in a hospital or ambulatory surgery center.
- Procedures there are often more expensive for the patient and the insurer
- Hospital and ambulatory surgery centers do not offer the convenience of the “home-like” atmosphere found in your physician’s office.
- You will be there—hospital or ASC–many additional hours dealing with the various “systems” imposed by hospitals and ASCs. Although hospitals and ASCs do a wonderful job they are not designed to tailor their routines to your individual needs. This often adds significant time and cost to their procedures.
Hospitals and ASCs do a very good job but theirs’ is a “one size fits all” approach to diagnostic hysteroscopy. At the Center for Menstrual Disorders we are able to offer a range of pain control services based on the patient’s needs. Our pain management is individualized. The one important benefit we offer is that you can begin a procedure with little or no sedation–if you wish—and then you can ask for additional medication, as you see fit, in order to get you through the procedure. If you wish you can simply decide to be asleep for the entire procedure and have no memory of it.
2. A FAMILIAR ENVIRONMENT
One of the attractive features of office based procedures is that you’re already familiar with the environment. You already know how to get here and where to park your car. You’ll recognize the staff and you may have already seen our procedure room. The atmosphere is designed to be “home-like” and we feel it is a far more relaxing atmosphere than you’ll generally experience in most ASCs or hospitals today.
3. COST
In general the out-of-pocket costs for most women is significantly less for an office-based procedure at the Center for Menstrual Disorders than the same procedure performed in a hospital or ASC. Please check with your insurer or ask one of our staff to check for you and compare.
4. COMMUNICATION
Not only are hospitals and ASCs larger and more complex providers of health care but often you feel that there is no one around to answer questions for you, your family members or loved one. Because this is an accredited office-based surgery center I am always here! I am available–to anyone that you’ve designated–to share medical information with anyone you wish.
5. SPECIALIZED EQUIPMENT
Hospitals spend a great deal of money purchasing and maintaining capital equipment often bring you, the consumer, advanced medical equipment and know-how. And while that’s true the same cannot be said of the limited field of hysteroscopy.
Because we specialize in menstrual disorders we have a vast array of hysteroscopes that are meant to accommodate many different situations that can unexpectedly arise. I am not making a boisterous claim in stating that we have a greater variety of specialized hysteroscopy equipment presently unavailable in any hospital or ASC in Western, New York. We do. The reason is simple. I am a specialist in a very narrow area of gynecology—hysteroscopy and hysteroscopic surgery. We invest in unique equipment that is presently unavailable in local hospitals and ASCs.
6. KNOWLEDGEABLE STAFF & MOBILE ANESTHESIA
Hysteroscopy requires a dedicated staff. Our nurses and technicians assist on hundreds of cases each year. Some of our staff have been with me for over 25 years! Two of our nurse practitioners have even published articles in scientific journals.
Since 2017 we have been proud to offer the services of MOBILE ANESTHESOLOGISTS, an accredited office-base anesthesia group. The physicians at MOBILE ANESTHESIOLOGISTS have performed many hundreds of cases for our patients and offer experienced and superior care.
7. EXPERIENCE, EXPERIENCE, EXPERIENCE!
We make no claim to be the best at what we do. But I have been performing office hysteroscopy for over 30 years and have completed many thousands of diagnostic and operative procedures.
REFERENCES
- Bradley LD, Widrich T. State-of-the-art flexible hysteroscopy for office gynecologic evaluation. J Am Assoc Gynecol Laparosc. 1995; 2(3):263-7