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Hysteroscopy: Diagnostic
Description
Diagnostic hysteroscopy describes a number of techniques that allow the direct inspection of the endometrial cavity, endocervix, and fallopian tube ostia.
Indications
Dysfunctional uterine bleeding, postmenopausal bleeding, menorrhagia, abnormal endometrial thickening documented by ultrasonography, retained intrauterine contraceptives or other foreign bodies, infertility (eg, suspected Müllerian anomalies), endometrial or pelvic infections (eg, tuberculosis), surveillance of (treated) endometrial cancer or other situations in which a visual or tissue diagnosis is indicated. Because of its more invasive nature, cost, and small, but not insignificant, risk for perforation or infection, this procedure is best suited for diagnosis and not screening.
Contraindications
Patients who are medically unstable, viable (desired) pregnancy, known cervical or uterine cancer, active pelvic inflammatory disease, blood dyscrasia, active herpetic infection. Office hysteroscopy is a poor choice for patients who have cervical stenosis, high levels of anxiety, comorbidities, limited mobility, in whom there is difficulty visualizing the cervix, or the presence of uterine pathology that may require operative procedures.
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