A European Society for Gynaecological Endoscopy survey of hysteroscopic practice.

Background: Hysteroscopy is recognised as the gold standard for diagnosing and treating intrauterine pathologies. Despite its broad acceptance, management practices appear to be diverse. Objectives: To explore gynaecologists' approaches to managing intrauterine pathologies, assessing their diagnostic habits, therapeutic strategies, and the surgical techniques adopted in clinical practice. Methods: The project was undertaken by the European Society for Gynaecological Endoscopy (ESGE) Special Interest Group on hysteroscopy. All ESGE members were invited to participate in the study through an online questionnaire hosted on the SurveyMonkey platform. Main Outcome Measures: Procedural setting, equipment availability, preferred instruments, pain management, and satisfaction with hysteroscopic practices. Results: Four hundred and fifty-one of 4000 (11.25%) gynaecologists from 57 countries responded. Two hundred eighty one (74%) of the participants performed hysteroscopy using a vaginoscopic approach. Pain management practices varied, with 46% of respondents reporting minimal or no use of analgesics. Procedural settings were distributed across office-based environments 107 (23.7%), outpatient facilities 183 (40.6%), and operating rooms 161 (35.6%). Two hundred and ninety-nine (87.9%) of respondents reported that diagnostic facilities were well-equipped, and 282 (74.4%) expressed satisfaction with the available operative equipment. Polypectomy was the most frequently performed operative procedure. Conclusions: The observed variability in the practice of hysteroscopy among ESGE members highlights the need for standardised guidelines to improve consistency and patient outcomes. What is New?: This survey provides an overview of the hysteroscopic management of intrauterine pathologies among ESGE members.