Indications
Hysteroscopy is useful in a number of uterine conditions:
- Asherman's syndrome (i.e. intrauterine adhesions). Hysteroscopic adhesiolysis is the technique of lysing adhesions in the uterus using either microscissors (recommended) or thermal energy modalities. Hysteroscopy can be used in conjunction with laparascopy or other methods to reduce the risk of perforation during the procedure.
- Endometrial polyp. Polypectomy.
- Gynecologic bleeding
- Endometrial ablation (Some newer systems specifically developed for endometrial ablation such as the Novasure do not require hysteroscopy)
- Myomectomy for uterine fibroids.
- Congenital uterine malformations (also known as Mullerian malformations).
- Evacuation of retained products of conception in selected cases.
- Removal of embedded IUDs.
The use of hysteroscopy in endometrial cancer is not established as there is concern that cancer cells could be spread into the peritoneal cavity.
Hysteroscopy has the benefit of allowing direct visualization of the uterus, thereby avoiding or reducing iatrogenic trauma to delicate reproductive tissue which may result in Asherman's syndrome.
Hysteroscopy allows access to the utero-tubal junction for entry into the Fallopian tube; this is useful for tubal occlusion procedures for sterilization and for falloposcopy.
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