hysteroscope

A hysteroscope is a slender, noninvasive endoscope used to inspect the interior of the uterus. In a procedure called hysteroscopy, clinicians can diagnose conditions and perform limited surgery within the uterine cavity using the hysteroscope, often on an outpatient basis.

Hysteroscopes come in rigid and flexible forms and may be rod-lens or fiber-optic with a small camera and light source. The uterine cavity is typically distended with sterile fluid or, less commonly, a nonconductive distention medium to improve visibility and space for instrumentation.

Common indications include evaluation of abnormal uterine bleeding, infertility workup, recurrent pregnancy loss, suspected intrauterine polyps, fibroids, adhesions, and congenital uterine anomalies. Hysteroscopy can also be used to guide targeted biopsies or sterilization procedures.

The procedure is usually performed with the patient under local, regional, or general anesthesia, and often in an outpatient setting. The cervix is dilated slightly to allow passage of the hysteroscope; the uterus is then inspected while fluids or gases distend the cavity. Additional instruments may be introduced through the hysteroscope for biopsy or treatment.

Operative hysteroscopy uses instruments such as grasping forceps, scissors, resectors, or laser/electrosurgical devices to remove polyps or fibroids, trim adhesions, or perform endometrial ablation, depending on the pathology and device availability.

Risks are generally low but include uterine perforation, infection, excessive fluid absorption (hydro- or electrolyte imbalance), bleeding, and vasovagal episodes. Outcomes are favorable with expertise and proper patient selection.