Hysteroscopy is generally a low risk technique that uses the endocervical canal, the natural passageway of the body, to gain entry into the uterine cavity. Refinement of optical and fiberoptic light instrumentation and of operative accessories allow high resolution and excellent visual documentation by hysteroscopy.
Diagnostic hysteroscopy is an intrauterine examination without the expectation of a therapeutic intervention. Accurate knowledge of the position of the uterus is critical to facilitate the examination. The best time to perform a diagnostic hysteroscopy is during the proliferative phase of the menstrual cycle. The patient is placed in lithotomy position and perineum and vagina prepared with povidone iodine. Sims retractor retracts the posterior vaginal wall and the cervix is visualized.
- Operative hysteroscopy is a minimally invasive gynecological procedure in which an endoscopic optical lens is inserted through the cervix into the endometrial cavity to direct treatment of various types of intrauterine pathology. Operative hysteroscopy became popular after improvements in endoscopic technology and instruments in the 1970s and after the introduction of fluid distension media in the 1980s. Since that time, the development of new hysteroscopic instruments, fiber optics, and digital video equipment has continued to provide more varied, efficacious, and less invasive procedures. The introduction of smaller-diameter hysteroscopes has allowed operative hysteroscopy to become a predominately office and outpatient procedure.
- Abnormal uterine or heavy menstrual bleeding
- Submucosal leiomyoma
- Uterine polyps
- Uterine septum
- Lysis of adhesions
- Cannulation of fallopian tube ostia
- Removal of a foreign body