Overview

Hysteroscopy is a minimally invasive procedure used to visualize the uterine cavity using a hysteroscope. It can be diagnostic or operative.

Hysteroscopy is crucial for diagnosing and treating intrauterine pathologies like polyps, fibroids, and septa. It provides direct visualization of the uterine cavity.

Learn more in our comprehensive RxDx OBG Course

Indications

✓
Abnormal Uterine Bleeding

Heavy or irregular bleeding

✓
Infertility Evaluation

Assessment of uterine cavity

✓
Recurrent Miscarriage

Evaluation of uterine anomalies

✓
Suspected Polyps/Fibroids

Intrauterine pathology

✓
Postmenopausal Bleeding

Evaluation of bleeding

Contraindications

Absolute Contraindications

✗ Patient refusal
✗ Pregnancy
✗ Active pelvic infection

Relative Contraindications

✗ Cervical stenosis
✗ Heavy bleeding
✗ Coagulopathy

📋 Equipment Checklist

Check off items as you gather them:

Pre-procedure Preparation

Preparation includes patient consent, anesthesia, sterile technique, and proper positioning. All equipment should be ready.

Step-by-Step Procedure

Step 1: Patient Preparation

Explain procedure, obtain consent, position patient.

⚠️ Common Mistakes to Avoid:

  • Inadequate consent
  • Poor positioning

💡 Pro Tip:

Position patient in lithotomy position.

Step 2: Anesthesia

Administer local or general anesthesia.

⚠️ Common Mistakes to Avoid:

  • Inadequate anesthesia
  • Wrong type

💡 Pro Tip:

Use appropriate anesthesia.

Step 3: Cervical Dilation

Dilate cervix if needed.

⚠️ Common Mistakes to Avoid:

  • Too rapid dilation
  • Cervical trauma

💡 Pro Tip:

Dilate gradually if needed.

Step 4: Scope Insertion

Insert hysteroscope into uterine cavity.

⚠️ Common Mistakes to Avoid:

  • Wrong technique
  • Cervical trauma

💡 Pro Tip:

Insert scope gently.

Step 5: Cavity Examination

Systematically examine uterine cavity.

⚠️ Common Mistakes to Avoid:

  • Incomplete examination
  • Missed pathology

💡 Pro Tip:

Examine all areas systematically.

Step 6: Intervention

Perform any necessary procedures.

⚠️ Common Mistakes to Avoid:

  • Incomplete procedure
  • Complications

💡 Pro Tip:

Perform procedures carefully.

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Post-procedure Care

Post-procedure care involves monitoring for complications, pain management, and patient education.

Complications & Management

Complication Incidence Signs Management Prevention
Uterine perforation 1-3% Abdominal pain, bleeding Laparoscopy, observation Gentle technique
Cervical trauma 2-5% Cervical bleeding Suturing, pressure Gentle dilation
Infection 1-3% Fever, foul discharge Antibiotics Sterile technique
Fluid overload 1-2% Hyponatremia, confusion Fluid restriction, monitoring Monitor fluid balance

Clinical Pearls

💡

Use appropriate distension media.

🎯

Examine cavity systematically.

⚡

Monitor fluid balance carefully.

🔍

Document all findings thoroughly.

📊

Use sterile technique throughout.

🎨

Handle instruments carefully.

⚠️

Monitor for complications post-procedure.