Contraindications for operative and diagnostic hysteroscopy
Absolute contraindications
• Cervical cancer: hysteroscopy should not be performed in the presence of cervical cancer because of the danger of opening blood or lymphatic vessels and causing systemic dissemination of malignant cells.
• Heavy uterine bleeding: hysteroscopy should be avoided during menstruation, because of a theoretical risk of dissemination during endometriosis and mainly because the view is limited and unsatisfactory. Moderate uterine bleeding does not prevent adequate visualization of the uterine cavity.
• Pelvic inflammatory disease: due to the danger of causing extended ascending infection and peritonitis.
Relative contraindications
• Pregnancy: generally considered a contraindication to hysteroscopy but it may be necessary to perform hysteroscopy to remove an IUD.
• Recent uterine perforation: the risk of repeat uterine perforation is considered greater in such cases as the healing process may have left a weak scar.
• Cervical stenosis: the risk of uterine perforation is considered greater in such cases; the importance of an experienced operator cannot be overstated.
• Cardiorespiratory disease.
• Uncooperative patient: although this can be overcome using the vaginoscopic technique