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Nowadays, hysteroscopy is the gold standard for the diagnosis and treatment of intrauterine pathologies as it represents a safe and minimally invasive procedure that allows the visualization of the entire uterine cavity. Numerous technological innovations have occurred over the past few years, contributing to the development and widespread use of this technique. In particular, the new small-diameter hysteroscopes are equipped with an operating channel in which different mechanical instruments can be inserted, and they allow not only to examine the cervical canal and uterine cavity but also to perform biopsies or treat benign diseases in a relatively short time without anesthesia and in an outpatient setting. In this scenario, the operator must be able to perform hysteroscopy in the correct way to make this procedure increasingly safe and painless for the patient. This review aims to describe the ten steps to perform a correct office hysteroscopy, starting from patient counseling to the therapy after the procedure.

The aim of this study was to assess the safety, effectiveness and advantages of a new surgical technique for the extraction of endometrial polyps after in-office hysteroscopic polipectomy. Between November 2009 and September 2013, 140 pre- and post-menopausal women with a sonographic diagnosis of endometrial polyps underwent polypectomy in-office hysteroscopy, followed by lesion removal using classical surgical instruments or the new REP-b technique. A total of 70 women underwent endometrial polyp removal using the new surgical technique REP-b (GROUP A), and 70 women received endometrial polyp removal using classical surgical instruments (GROUP B). The extraction time Tr, calculated as the time from the introduction of the basket into the operative hysteroscopic sheath to the complete removal of the previously sectioned polyp, in GROUP A (REP-b technique) was significantly lower compared with GROUP B (control group). The median Tr for GROUP A was 29.50 s versus the median Tr for GROUP B of 54.00 s (P< 0.01). The use of the REP-b technique improves the outcome of the operation and reduces the extraction time for the removal of endocavitary uterine lesions.

Cystocele is the most common pelvic organ prolapse. It is defined as the descent of the bladder into the anterior vaginal wall. Aging is significantly associated with the prevalence and severity of pelvic organ prolapse. Treatment may be conservative or surgical according to symptoms, prolapse degree and not forgetting both patient and doctor preferences. Identify the most efficient surgical treatment to treat cystocele and its recurrences. Scientific literature was reviewed searching PubMed/MEDLINE database for articles published between 1996 and 2015 and using the terms pelvic organ prolapse, cystocele, mesh surgery, traditional repair, pelvic organ prolapse recurrence, complications, sexual function. There are two different surgical approaches for the treatment of cystocele: traditional repair and mesh repair. Prosthetic treatment gives higher anatomical success rate and fewer recurrence while traditional anterior repair has less complications. Surgical treatment in general improves both the anatomical success rate and the quality of life. The choice of surgery, between traditional and mesh repair, has to be personalized related to the prolapse grade and women tissues.