In this video, we will discuss that Diagnostic hysteroscopy is a safe and minimally invasive procedure that allows direct visualization of the endocervical canal and uterine cavity using a hysteroscope. It is considered the gold standard for evaluating abnormal uterine bleeding, infertility, recurrent miscarriage, suspected intrauterine lesions, and congenital anomalies. In this video titled "Diagnostic Hysteroscopy: A Step-by-Step Guide to Uterine Cavity Evaluation," viewers are guided through the systematic approach to performing hysteroscopy, highlighting best practices for safe and effective execution.

Step-by-Step Procedure Demonstrated in the Video

Patient Preparation and Positioning
The patient is placed in the lithotomy position with bladder emptied.
Informed consent is obtained and vitals are monitored.
Antiseptic cleaning of the vulva and vagina is performed before the procedure begins.

Selection of Hysteroscope

A rigid or flexible hysteroscope is selected based on the indication. For office-based procedures, a 5 mm or smaller hysteroscope with a no-touch vaginoscopic technique is preferred to avoid speculum and tenaculum use.

Cervical Entry

The hysteroscope is gently introduced through the external cervical os, navigating the cervical canal into the uterine cavity. No dilatation is needed for office hysteroscopy.

Uterine Cavity Distension

The cavity is distended using normal saline or CO₂ for clear visualization. The intrauterine pressure is carefully regulated to avoid fluid overload or vasovagal reactions.

Systematic Cavity Evaluation

A thorough inspection is done starting from the cervical canal, moving into the uterine fundus, lateral walls, posterior and anterior walls, and both tubal ostia.

Attention is paid to identifying polyps, submucosal fibroids, synechiae (adhesions), hyperplasia, or septal anomalies.

Documentation and Optional Biopsy

Visual findings are recorded through video or image capture. In case of any suspicious lesions, a directed biopsy can be taken using hysteroscopic instruments.

Post-Procedure Care

The hysteroscope is carefully withdrawn, and the patient is observed for a short period. Most patients experience minimal discomfort and can resume normal activities the same day.

Clinical Applications of Diagnostic Hysteroscopy

Investigation of abnormal uterine bleeding
Evaluation of infertility and repeated implantation failure
Assessment of congenital uterine anomalies (e.g., septate uterus)
Diagnosis of intrauterine adhesions (Asherman’s syndrome)
Direct visualization of endometrial pathology

Conclusion

This video demonstration of diagnostic hysteroscopy offers an insightful, practical guide to performing a safe, efficient, and highly informative procedure for uterine evaluation. Its minimal invasiveness, real-time visualization, and ability to identify subtle intrauterine pathology make it a cornerstone in modern gynecologic diagnostics.

Watch the full video to learn the correct technique, instrumentation, and interpretation of findings during diagnostic hysteroscopy. Don’t forget to like, comment, and subscribe for more gynecologic surgical training and procedural education.