Hysteroscopy in daily practice

Abstract

In the recent past, the established method for investigating women with abnormal uterine bleeding was dilatation and curettage. When hysteroscopic examination of the uterus proved to be more accurate, diagnostic hysteroscopy with or without endometrial sampling was suggested as the method of choice. The small diameter scopes with working- channels combined with the vaginoscopic approach have caused a shift from the inpatient setting to an ambulatory one without anaesthesia. Likewise, the introduction of several new surgical techniques has improved handling of instruments, patient safety and therapeutic options. This thesis deals with the implementation of hysteroscopic surgery in The Netherlands, the diagnostic accuracy of hysteroscopy, the patient preference with regard to the method of examining the uterine cavity, and the effectiveness of several hysteroscopic applications in the treatment of abnormal uterine bleeding.