Abstract
Abnormal uterine bleeding (AUB) represents a common clinical problem facing the gynecologist. The difficulties encountered in identifying specific physiologic, organic, or pathologic causes often lead to medical and surgical strategies that focus on correcting symptoms or providing treatment without first making a definitive diagnosis.
The prevalence of AUB, the difficulties in identifying its causes, and the cost of management argue for reliable diagnostic techniques and treatment strategies. An ideal approach would promptly identify patients with organic disease, facilitate patient comprehension and choice of treatment options, improve treatment efficacy, and reduce overall cost of care.
Hysteroscopy can have an important role in the management of AUB. Easily accomplished in an office or outpatient setting with little or no analgesia or anesthesia, hysteroscopy provides direct access to the uterine cavity. Intrauterine visualization when displayed on a video screen encourages and facilitates patient-physician dialogue, allowing thorough informed consent regarding subsequent medical or surgical interventions. Moving the procedure from a hospital setting to the physician's office significantly reduces cost. This article reviews the history, instrumentation, diagnostic and operative techniques, and potential complications of hysteroscopy in the management of AUB.