Hysteroscopy : A Clinical Experience with 1300 Patients

Shin, J O; Oh, S T

Abstract

Hysteroscopy has added a new dimension to the management of patients with common clinical problems, increasing the accuracy of diagnosis and serving as an adjunct in treatment of intrauterine conditions. This report summarizes the hysteroscopic experience with 1300 selected patients, 837 with suspected uterine synechiae on hysterosalpingography, 158 with abnormal uterine bleeding, 133 with space-occupying lesion in uterine cavity on hysterosalpingography or ultrasonography, 78 who underwent hysteroscopy for location and retrieval of intrauterine contraceptive devices, 36 with suspected uterine anomalies on hysterosalpingography, 32 who underwent hysteroscopy for tubal catheterization of proximal tubal obstruction, 23 with possible retained productions of conception, 3 with possible intrauterine foreign body. Anesthesia was achieved successfully with I.V of meperidine and diazepam. Uterine distension was achieved with 1.5% glycine in all patients. In 90.5 per cent of the patients, visually recognizable or pathologically suspicious intrauterine abnormalities were found. This study further demonstrated the utility of hysteroscopy in diagnosis of endometrial polyps, uterine submucous leiomyomas, uterine malformations, and intrauterine adhesions. Hysteroscopy was also helpful in taking directed biopsies of selected areas of the endometrium in patients with adenomatous hyperplasia and early adenocarcinoma of the endometrium and helpful in removal of intrauterine foreign bodies and evaluation of the recently pregnant uterus when there was a question of persistent pregnancy. Hysteroscopy is a safe ambulatory procedure that is appealing to both patient and gynecologist in its economy and simplicity.