Hysteroscopy

Hysteroscopy (direct endoscopic visualization) of the endometrial cavity is an exciting and rapidly developing field of gynaecological practice. The most dramatic advances have occurred during the last 20 years due to technological advances including miniaturization of equipment and improved optics. Hysteroscopy is used both diagnostically and therapeutically to treat a wide range of gynaecological problems (heavy menstrual bleeding, infertility, and postmenopausal bleeding). The most recent advances allow accurate direct visualization of the uterine cavity which provides a platform for targeted biopsies, safe removal of endometrial polyps, and treatment of fibroids, septa, and adhesions. Proper training has resulted in a low incidence of serious complications. The current consensus is that hysteroscopy provides a gold standard not only for evaluating and treating intrauterine pathology but also for allowing a minimalist approach which has resulted in improved patient outcomes. This chapter provides an overview of the current state of this exciting and evolving field.