Evaluation of diagnostic and therapeutic hysteroscopy outcomes at a tertiary hospital in Rwanda.

BACKGROUND

Hysteroscopy is a minimally invasive technique for diagnosing and managing intrauterine pathologies, critical in addressing reproductive health issues. In Rwanda, limited data exist regarding the practice and outcomes of hysteroscopic procedures. Therefore, the objective of this study is to evaluate the practice, diagnostic and therapeutic outcomes, and patient-reported results of hysteroscopy performed at the University Teaching Hospital of Kigali (CHUK) from March 2022 to February 2025.

METHODS

This retrospective and prospective study included 62 women who underwent hysteroscopy at CHUK. Data collected encompassed demographic details, indications, procedural characteristics, outcomes, and follow-up outcomes. Descriptive statistics and bivariate analyses assessed clinical findings, complication rates, efficacy of treatments, and factors associated with symptom improvement.

RESULTS

A total of 62 women underwent hysteroscopic procedures within the study period. The mean age was 42 years (±6.4 years), with 74% aged between 30 and 50 years. Most participants were premenopausal (74%) and had attained at least secondary education (50%). The predominant indications for hysteroscopy were abnormal uterine bleeding (59.68%) and infertility (25.8%). Diagnostic hysteroscopy accounted for 52.2% of cases, while therapeutic procedures comprised 46.8%. The most common hysteroscopic findings included endometrial polyps (33.9%), intrauterine adhesions (16.1%), and fibroids (16.1%), with 25.8% showing a normal cavity. The majority of procedures (77.4%) lasted less than an hour, and the complication rate was 4.8%. Most patients (72.6%) had their intrauterine pathology successfully treated during the procedure.

CONCLUSIONS

Hysteroscopy in Rwanda demonstrates favorable diagnostic yield and therapeutic outcomes, with minimal complications. The increasing adoption of office-based procedures and targeted management of intrauterine lesions can enhance patient care. These findings support the expansion of hysteroscopic services and capacity building in the region.