This review discusses advances in hysteroscopy in the past decade, including the introduction of small-caliber
endoscopes, microhysteroscopy, the flexible steerable
hysteroscope, and the use of video systems in monitoring hysteroscopic evaluations. Media for uterine distension are reviewed and possible complications of the use of
dextran 70 are discussed. Hysteroscopy is superior to
curettage for evaluating abnormal
uterine bleeding. Hysteroscopy can be used as an adjunct to hysterosalpingography, endometrial biopsy, and laparoscopy in evaluating
infertility, and in detecting and treating intrauterine adhesions. The method has also been applied to the division of uterine septa, the removal of submucous
leiomyomas, and tubal cannulation both for treating
tubal obstruction at the cornual areas and in conjunction with new reproductive technologies. The use of the microcolpohysteroscope to tailor the size and extension of a cervical conization is described. Finally, hysteroscopy permits evaluation of the extension and involvement of the endocervical canal in patients with endometrial
neoplasia and offers an important guide in staging and planning treatment for this condition.