Diagnostic and Operative Hysteroscopy

The aim of this book is to critically review different aspects of hysteroscopy with recognized experts from the United States and Europe. The main objective is to provide a balanced view of current clinical opinion and to review the rapidly expanding world of hysteroscopy. This book begins with an extensive review of the anatomy, histology, physiology, and pathology of the endocervix and uterine cavity. Then the role of the OR nurse and personnel is outlined, setting out disinfection and sterilization guidelines of the different elements of the hysteroscopy. Hysteroscopy offers direct vision of the uterine cavity and the possibility to perform directed biopsies of suspicious areas. There are special hysteroscopes that evaluate lesions to different degrees and some even reach the nucleus-cytoplasm level. Other benign alterations like endometrial polyps or submucous fibromyomas can also produce pathological conditions that require treatment. Chapter 4 is devoted to different image methods that can be used as screening tests (TVUS, HSSG) or as an aid to define diagnosis (HSG, MRI). The use of hysteroscopy in reproductive problems is studied in Chapter 5. Different indications for these problems are described, both diagnostic and operative, in infertility and repeated pregnancy loss patients. Other chapters include specific pathologies in this field as uterine septa or intrauterine adhesions. There are several genital tract malformations in which hysteroscopy is an effective method of diagnosis and treatment when infertility is evaluated. In the field of reproduction, synechiolysis or septolysis are well-known applications. Salpingoscopy, tubal cannulation, or hysteroscopic sterilization are examples of how this technique is continuously growing. The transcervical embryoscopy is also studied. Chapters 6 and 7 offer an extensive revision for the hysteroscopic diagnosis and management of endometrial hyperplasia and endometrial adenocarcinoma, given the different presentations that these pathologies can show. For endometrial resection or ablation, this book is limited to hysteroscopic techniques and not to other techniques.