{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T17:03:46Z","timestamp":1780506226187,"version":"3.54.1"},"reference-count":31,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2022,6,15]],"date-time":"2022-06-15T00:00:00Z","timestamp":1655251200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Failure to obtain an office\u2010based endometrial biopsy for abnormal uterine bleeding is not uncommon. Although operating room\u2010based procedures are traditionally considered the gold standard assessment tool in these circumstances, outpatient hysteroscopy is a less invasive, more cost\u2010effective, and safer alternative. However, there is no contemporary Canadian literature on the effectiveness of an outpatient approach for this specific population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>We aim to evaluate the effectiveness and outcomes of outpatient hysteroscopy for uterine cavity evaluation for patients who have failed an in\u2010office endometrial biopsy attempt.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective cohort study of all patients referred to an academic outpatient hysteroscopy unit between January 2015 and January 2018, who underwent an outpatient hysteroscopy following failed endometrial biopsy. Data were collected from electronic medical records.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 407 consecutive patients who underwent an outpatient hysteroscopic procedure, 68 met inclusion criteria. Postmenopausal bleeding was the most common indication for initial biopsy, and most failures were attributed to cervical stenosis. Outpatient hysteroscopies were successfully completed in 96% of cases (<jats:italic>n<\/jats:italic>\u00a0=\u00a065\/68). Failure resulted from either anxiety and discomfort (<jats:italic>n<\/jats:italic>\u00a0=\u00a02), or severe intrauterine adhesions (<jats:italic>n<\/jats:italic>\u00a0=\u00a01). Overall, 10% of patients subsequently required an operating room\u2010based hysteroscopy, either to complete a myomectomy or polypectomy, or to allow general anesthesia. Outpatient hysteroscopy identified endometrial hyperplasia and cancer in 4.5% and 3% of patients, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Outpatient hysteroscopy following unsuccessful office endometrial biopsy attempts appears to be a feasible, safe, and cost\u2010effective investigation strategy that may prevent the need for an operating room\u2010based procedure in 90% of cases.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jog.15329","type":"journal-article","created":{"date-parts":[[2022,6,16]],"date-time":"2022-06-16T05:28:25Z","timestamp":1655357305000},"page":"2452-2458","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Outpatient hysteroscopy is effective for uterine cavity evaluation following failed office\u2010based endometrial biopsy"],"prefix":"10.1111","volume":"48","author":[{"given":"Dong B.","family":"Nguyen","sequence":"first","affiliation":[{"name":"Department of Obstetrics Gynecology and Newborn Care, The Ottawa Hospital &amp; University of Ottawa  Ottawa Ontario Canada"},{"name":"Faculty of Medicine University of Ottawa  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria E. M.","family":"Gerber","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Ottawa  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael W. 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