Hysteroscopy

Both diagnostic and simple operative hysteroscopy can be carried out in an office or clinic setting on suitably selected patients.

[4] Misoprostol prior to hysteroscopy for cervical dilation appears to facilitate an easier and uncomplicated procedure only in premenopausal women.

However, CO2 gas does not allow the clearing of blood and endometrial debris during the procedure, which could make the imaging visualization difficult.

Since the success of the procedure is totally dependent on the quality of the high-resolution video images in front of the surgeon's eyes, CO2 gas is not commonly used as the distention medium.

Glycine metabolizes into ammonia and can cross the blood brain barrier, causing agitation, vomiting and coma.

[6] If abnormalities are found, an operative hysteroscope with a channel to allow specialized instruments to enter the cavity is used to perform the surgery.

[12] Hysteroscopy has the benefit of allowing direct visualization of the uterus, thereby avoiding or reducing iatrogenic trauma to delicate reproductive tissue which may result in Asherman's syndrome.

Hysteroscopy allows access to the uterotubal junction for entry into the fallopian tube; this is useful for tubal occlusion procedures for sterilization and for falloposcopy.

Furthermore, cervical laceration, intrauterine infection (especially in prolonged procedures), electrical and laser injuries, and complications caused by the distention media can be encountered.

[citation needed] The use of insufflation (also called distending) media can lead to serious and even fatal complications due to embolism or fluid overload with electrolyte imbalances.

[1][6] Particularly the electrolyte-free insufflation media increase the risk of fluid overload with electrolyte imbalances, particularly hyponatremia, heart failure as well as pulmonary and cerebral edema.

[14][15] The former English Member of Parliament, Lyn Brown (West Ham, Labour), has spoken eleven times in the House of Commons on behalf of the Campaign Against Painful Hysteroscopy and constituents who have been coerced into completing unbearably painful outpatient hysteroscopies without anaesthesia.

Lyn Brown cites numerous instances of women throughout England being held down by nurses in order to complete an ambulatory hysteroscopy and thus avoid the expense of safely monitored sedation or general anaesthetic.

View of a submucous fibroid by hysteroscopy