Diagnostic office hysteroscopy with the Storz TrophyScope® versus Cooper surgical Endosee®.

Background: Office hysteroscopy (OH) is becoming increasingly popular. Our objective was to determine the use patterns, reported pain scores, and success rates of OH with the 2.9 mm Storz TrophyScope^® and handheld portable Cooper surgical Endosee^® device in a clinic without previous office hysteroscopy experience.

Methods: A prospective cohort study of a hysteroscopy quality improvement database was conducted in a tertiary care center gynecology clinic. Patients undergoing OH with either the Storz TrophyScope^® or Cooper Surgical Endosee^® device were included.

Results: Of the 171 office hysteroscopies, 77 utilized the TrophyScope^®, with 8 (10%) being inadequate, while 94 utilized Endosee^®, with 13 (14%) being inadequate (P=0.50). Of the 13 inadequate Endosee^® hysteroscopies, 4 (31%) were due to visualization, 4 (31%) to patient intolerance, 3 (23%) to cervical stenosis, and 2 (15%) to a combination of these factors. Of the 8 inadequate TrophyScope^® hysteroscopies, 7 (87%) were due to patient intolerance and 1 (13%) to cervical stenosis. Of the 150 adequate office procedures performed, 52 cases underwent subsequent procedures in the operating room (OR). Of these, 26 (84%) of 31 Endosee^® cases and 18 (86%) of 21 TrophyScope^® cases were in agreement with OR procedure findings. A subgroup analysis comparing mean pain levels did not significantly differ between the two hysteroscopes.

Conclusions: There was no difference in accuracy with OR pathologic diagnoses, adequacy of procedure, and reported pain scores when comparing the TrophyScope® and Endosee® in this prospective cohort. Larger studies are needed to confirm the sensitivity, and specificity for these newer, disposable office hysteroscopic devices.