[Operative hysteroscopy]

It is essential and necessary therapeutic tool in the management of intrauterine pathologies. Indeed, it has facilitated the reach of these lesions and offers many advantages as a minimally invasive technique for either patients or physicians. Retrospective study on a series of 79 cases of operative hysteroscopy performed between January 2004 and December 2006. The mean age of patients was 43.7 years. Gestures made were: polypectomy in 27 cases [34.2%], myomectomy in 17 cases [21.5%], endometrial ablation in 14 cases [17.7%], septum resection in nine patients [11.4%], resection of trophoblastic tissue in two patients [2.5%]. Incidents and accidents during surgery accounted for 2.5%. This technique has now gained an important place in the field of gynecologic endoscopy, endo-uterine resection of intracavitary fibroids and endometrial polyps, the endometrectomy, cure of partition and synechiae are currently codified. Moreover, literature reports a net long-term improvement of clinical signs after hysteroscopic treatment, with improved pregnancy rates and embryo implantation. Hysteroscopy is currently the gold standard as a therapeutic technique for intrauterine lesions. However it has limits and not without complications

[Diagnostic hysteroscopy]

It is an essential and necessary tool in the management of intrauterine pathologies. Indeed, it allows a better diagnosis and better distribution of therapeutics, more precisely targeted. It is a quick, minimally invasive, reproducible and reliable. Retrospective study on a series of 174 cases of diagnostic hysteroscopy performed between January 2004 and December 2006. The mean age was 42,6 years; abnormal uterine bleeding is the main symptom in 110 patients [63%], followed by infertility in 30 patients [17.2%], the abortive disease [7.5%], removal of the intrauterine device [6.9%], and others [5.1%]. Nine patients [5%] had a normal examination; intrauterine abnormalities found were: polyps [31.6%], endometrial hypertrophy [32%], submucous adenomyomas [13.8%], synechiae [12%], endometrial atrophy [9.7%], the intrauterine device [6.9%], uterine septum [6.3%], trophoblast retention [3.5%], intraluminal neoplasms [1.7%], and adenomyosis [1.7%]. The hysteroscopy is accurate, safe, with a low failure rate in the diagnosis of intrauterine abnormalities. It has better sensitivity and specificity compared with sonography and hysterosalpingography. It involves certain risks, but generally remains rare. This examination is currently the gold standard as a diagnostic technique for intracavitary uterine lesions