Endoscopic office hysteroscopy is a minimally invasive procedure that allows gynecologists to visually examine the inside of a woman’s uterus using a hysteroscope – a slender, tube-like instrument with a light and camera attached to it. The procedure is typically performed in a gynecologist's office or outpatient clinic, and it does not require general anesthesia.

During the procedure, the hysteroscope is inserted into the uterus through the cervix. The camera attached to the hysteroscope transmits real-time images of the inside of the uterus to a monitor, allowing the gynecologist to examine the uterine cavity for abnormalities such as polyps, fibroids, adhesions, and other conditions that can cause abnormal uterine bleeding, infertility, or other symptoms.

Endoscopic office hysteroscopy is a safe and effective diagnostic and therapeutic tool for women with abnormal uterine bleeding, suspected intrauterine pathology, infertility, and other gynecological conditions. The procedure can be performed in an outpatient setting, and patients can usually return to their normal activities shortly after the procedure.

Indications

Endoscopic office hysteroscopy is typically performed in women who experience abnormal uterine bleeding or have other symptoms related to the uterus, such as infertility, recurrent miscarriages, or pelvic pain. The procedure is also used for diagnostic purposes in women who have abnormal Pap test results or suspected intrauterine pathology, such as polyps or fibroids.

The most common indications for endoscopic office hysteroscopy include:

• Abnormal uterine bleeding, such as heavy or prolonged menstrual bleeding, bleeding between periods, or postmenopausal bleeding
• Infertility or recurrent miscarriages
• Pelvic pain or pressure
• Suspected intrauterine pathology, such as polyps, fibroids, or adhesions
• Abnormal Pap test results

Contraindications

Endoscopic office hysteroscopy is generally safe and well-tolerated by most women. However, there are some contraindications to the procedure that should be considered before proceeding.

The most common contraindications include:

• Pregnancy:- Endoscopic office hysteroscopy is not recommended for pregnant women because it can increase the risk of miscarriage or preterm labor.
• Active pelvic infection:- Women who have an active pelvic infection, such as pelvic inflammatory disease, should not undergo endoscopic office hysteroscopy until the infection has been treated and resolved.
• Cervical stenosis:- Women with cervical stenosis, a condition in which the opening of the cervix is narrowed or blocked, may not be able to undergo endoscopic office hysteroscopy. In some cases, cervical dilation may be necessary before the procedure can be performed.
• Uterine perforation:- Women with a history of uterine perforation or other uterine abnormalities may not be good candidates for endoscopic office hysteroscopy.

Procedure

Endoscopic office hysteroscopy is typically performed on an outpatient basis and does not require general anesthesia. The procedure usually takes 15 to 30 minutes to complete, depending on the reason for the examination and the findings.

Before the procedure, the patient may be given a mild sedative to help her relax. The patient will lie on her back on an exam table with her feet in stirrups, similar to a pelvic exam. The gynecologist will insert a speculum into the vagina to visualize the cervix.

The cervix may be dilated with a series of small dilators to allow the hysteroscope to pass through. Once the cervix is dilated, the hysteroscope is inserted into the uterus, and the camera attached to the hysteroscope transmits real-time