Background: Office hysteroscopy is not widely accepted compared to conventional hysteroscopy among women in Hospital Canselor Tuanku Muhriz due to perception of pain without general or regional anaesthesia. This randomized controlled trial was performed to evaluate success rate, level of pain score, endometrial sampling and complications of both procedures.

Study Objective: To assess the success in achieving diagnosis for women with abnormal uterine bleeding by office hysteroscopy versus conventional hysteroscopy. To compare the pain score, safety and adverse events during both procedures.

Materials and Methods: A randomized controlled trial in which all participants that fulfilled the inclusion criteria were recruited. The study was conducted in Hospital Canselor Tuanku Muhriz from December 2015 until May 2016. A total of 80 women were recruited. Patients were randomly assigned to receive either office hysteroscopy or conventional hysteroscopy using Excel Micro software in gynaecology clinic or ward. All data were recorded in an electronic database and analysed using SPSS Version 23.0. Descriptive statistics were used to summarize the characteristics of the study population. The qualitative variables were expressed as frequencies and the quantitative variables were expressed as means in standard deviations. Statistical significance was calculated using the Chi square test when comparing qualitative data and the student t test for comparing quantitative data. P value of less than 0.05 was taken as significant.

Results: During the study period, 80 patients underwent hysteroscopy for abnormal uterine bleeding (AUB). The procedure was performed successful in 97.5% women without serious complication. Biopsy was taken in 97.5% of patients underwent office hysteroscopy while only 85% in the conventional hysteroscopy. Satisfactory endometrial sampling and tissue biopsy were higher in the office hysteroscopy group (80%) compared to the conventional group (67.5%) but this was not statistically significant (p value=0.204). In the office hysteroscopy group, 17.5% experienced unbearable pain and 5% of patients developed transient vasovagal attack. There were 52.5% of women had mild pain (score 1-4) and were reassured. 37.5% had moderate pain whereas only 10% had severe pain. At most, 35% patients required analgesia post procedure. All patients remained haemodynamically stable during and after the procedure.

Conclusion: Office hysteroscopy is an excellent outpatient minimally invasive operative procedure which offers exceptional patient’s compliance with low failure and complication rates.