Effectiveness of Office Hysteroscopy on a Patient’s Health-Related Quality of Life (HRQoL)

Introduction: An investigation was performed to determine the health-related quality of life (HRQoL) of patients’ pre-hysteroscopy, 2-weeks, and 6-8 weeks post-hysteroscopy intervention in pre-menopausal and post-menopausal patients, using the EuroQoL-5 Dimension-5 Level (EQ-5D-5L) health status questionnaires and EuroQol visual analogue scale (EQ-VAS). Methods: This prospective observational study was done from May 30, 2023, to May 13, 2024 (12-months), with a recruitment target of 120 patients, within a private practice setting. Women aged 18 and older meeting the inclusion criteria and being scheduled to undergo office hysteroscopy for diagnosis and treatment purposes were enrolled in our study. The inclusion criteria includes the diagnoses of abnormal uterine bleeding, heavy menstrual/postmenopausal bleeding, abnormal pelvic ultrasound (e.g. abnormal endometrial thickening or intrauterine lesions). The exclusion criteria includes pregnancy, active pelvic infection, confirmed cervical and/or endometrial cancer. Women who voluntarily withdrew from the study were also excluded. All enrolled patients completed patient-reported outcomes of EuroQoL-5D-5L health status questionnaires, their overall health rating on EQ-VAS before hysteroscopy, 2-week after hysteroscopy, and 6-8 weeks after hysteroscopy, respectively. Results: At this time in our study, we have not met our recruitment target of 120. A total of 123 patients were enrolled in our ongoing study, of which only 91 patients have completed the study (N=91), 17 patients were in the time frame to be followed, and 15 patients who could not tolerate office hysteroscopy or did not respond/complete self-reported EQ-5D-5L and EQ-VAS at 6-8 weeks post hysteroscopy, or withdrew voluntarily from the study were excluded from our study. HRQoL measured by mean EQ-5D-5L scores in the pain/discomfort showed statistically significant differences between pre-menopause group and postmenopausal group both before hysteroscopy and 2 weeks after hysteroscopy (both P < 0.05) ( Table 3 and Table 4). However, mean EQ-5D-5L scores in motility, self-care, usual activities, anxiety/depression, and overall health show no statistically significant difference between pre-menopausal group and post-menopause group before hysteroscopy and 2 weeks after hysteroscopy. Discussion: Office hysteroscopy exerts positive effects on HRQo in patients requiring the procedure, and it improves affected patients’ quality of life. It is the intent of the authors to bring attention to the measurement tools utilized in this study, the clinical importance of the quality of life, and the value of outpatient hysteroscopy for diagnosis and treatment purposes.