Hysteroscopy has evolved during the past century to become the gold standard for investigating the uterine cavity and the assessment of many conditions previously evaluated with blind and inaccurate techniques (dilatation and curettage). Hysteroscopy allows direct visualisation of the uterine cavity with the opportunity for targeted biopsy, safe removal of endometrial polyps, submucus fibroids and treatment of intrauterine septum and adhesions. Hysteroscopy is generally safe and efficient.
Other advantages are that the procedure can be conducted at a relatively low cost to the healthcare system and is convenient for the patient, as most of these procedures are performed on an outpatient or day-case basis.
The complication rate is low, whether hysteroscopy is used as a diagnostic or therapeutic tool; however, the procedure can be life-threatening in rare cases owing to complications (e.g. perforation of the uterus and damage to other organs). Appropriate training combined with understanding of the technique, equipment, troubleshooting and indications are mandatory for the safe and efficient utilisation of this useful tool.
When you have completed this tutorial you will be able to:
- assemble the hysteroscope and recognise the normal and abnormal appearance of the uterine cavity
- describe the instruments used in both diagnostic and operative hysteroscopy
- recognise the indications and technique of diagnostic, outpatient and operative hysteroscopy
- describe the main hysteroscopic procedures including:
- hysteroscopic polypectomy
- hysteroscopic myomectomy
- endometrial ablation
- hysteroscopic adhesiolysis
- hysteroscopic sterilisation
- recognise the complications encountered during hysteroscopic surgery and ways to prevent and manage them.
Last updated May 2017