Hysteroscopy: A useful diagnostic adjunct in gynecology

Advancements in instrumentation and the introduction of new media for uterine distention have enhanced the potential of hysteroscopy as a diagnostic technique. In a 10month period at the University of Minnesota, hysteroscopy was performed in 110 patients with suspected uterine pathology. Paracervical block anesthesia was used in 70 ambulatory patients and the remainder were investigated under general anesthesia because of concomitant laparoscopy or planned surgical intervention. Both dextran 30 per cent and 5 per cent dextrose in water were used for uterine distention. Hysteroscopic abnormalities were found in 70 per cent of the patients examined. These findings included endometrial polyps (32 patients), 12 intrauterine foreign bodies, submucous myomas (10 patients), developmental anomalies and cesarean section scar defects (7 patients), and 16 patients with miscellaneous pathologic conditions, including one patient with adenocarcinoma of the endometrium. In 33 patients the hysteroscopic findings were normal. In several patients intrauterine devices were removed under hysteroscopic control. There were no complications related directly to hysteroscopic observation.