Hysteroscopy in 100 patients

Seventy-five infertile patients and twenty-five in whom displacement of an intrauterine device (IUD) had occurred were examined under general anesthesia. The Storz 4-mm hysteroscope was utilized. In all cases Hyskon, high-molecular weight dextran, was used as the distention medium. Concurrent laparoscopy was performed in 80 patients. The hysteroscopic findings were compared with preoperative salpingograms or pelvic x-radiographs. In the infertility group the technique proved to be of special value in locating intrauterine adhesions which had not been detected radiologically. In the "lost IUD" group, hysteroscopy proved to be superior to radiography in determining whether or not a device was located within the uterine cavity, and greatly facilitated removal. Failure to carry out the procedure occurred in four patients. One suffered a serious complication: anaphylaxis to the dextran. It was concluded that hysteroscopy is a simple procedure carrying little risk. It is superior to hysterosalpingography in detecting intrauterine disease which may be a cause of infertility. It is greatly superior to radiology for the detection of lost IUDs.