ABSTRACT
Office hysteroscopy is defined as an office-based procedure performed under local anesthesia (OHULA). This pneumonic stands for OFFICE HYSTERSCOPY UNDER LOCAL ANESTHESIA. Most gynecologists perform hysteroscopy in outpatient surgery centers and hospitals. In fact only 20% of gynecologists perform hysteroscopy at all. More importantly, only 5% of gynecologists participate in office hysteroscopy. Factors that explain the low utilization of office hysteroscopy by gynecologists include lack of knowledge about this technique which is probably a reflection of lack of training in hysteroscopy in the residency program. Therefore, there is a lack of awareness about the diagnostic and therapeutic capability of hysteroscopy. The lack of training in local anesthesia for office hysteroscopy suggests a large reason for the minority of gyn participation in this technique. The fact that there is a significant money outlay for office hysteroscopy is probably the second most significant factor preventing gynecologists from involvement in this endeavor. The corollary is that reimbursement for office hysteroscopy is sorely lacking. The combination of all of these factors adds up to the lack of interest in office hysteroscopy. It is our hope that in the future these factors will change and that more gynecologists will perform office hysteroscopy.
