Oral and Poster Presentations

In our hospital, hysteroscopy is performed in theatre, with an outpatient service currently being set up for diagnostic procedures and treatment of small polyps. This audit was conducted to review our hysteroscopic workload, and estimate how much could be done in outpatients, in order to help reorganisation of services. A second aim was to examine our complication rates, comparing them with the RCOG Consent Advice on hysteroscopy. Methods Hysteroscopies conducted during a 6 month period were identified retrospectively from theatre lists. Data was collected with a predefined audit tool, and interpreted with Excel . Results 184 hysteroscopies were performed, 86 under the rapid access pathway and 44 for endometrial ablations. There was one uterine perforation (0.5%) and one case in which the uterine cavity could not be accessed (0.5%). There were no instances of major bleeding or visceral injury, but these are described as very rare or rare. Eight ablations could not be performed due to findings or device failure (18%), which highlights the need for appropriate patient selection, preoperative USS, patient counselling about this risk and senior supervision during the procedure to troubleshoot. After subtracting planned ablations, suspected large polyps (≥2 cm), simultaneous laparoscopies, those with documented anxieties surrounding examination or comorbidities precluding outpatient hysteroscopy, it was calculated that 112 cases (61%) could have been done in outpatients. This would be significantly cheaper, save theatre time, avoid general anaesthesia and provide trainees with opportunities in office gynaecology. This could be expanded to include patients with larger polyps and some ablations. 0004 Diagnosis and management of a rare case of a giant ovarian cyst mimicking ascites and containing 19 litres of fluid Papadakis, K; Karunyam, B Forth Valley Royal Hospital, Glasgow, UK; Dorset County Hospital NHS Foundation Trust, Dorchester, UK