Complications during hysteroscopy

Operative hysteroscopy is a mini invasive technique to treat uterine cavity diseases. As surgical technique, even if mini invasive, unfortunately it is not without risks and complications. By technology progresses some of the complications occur less frequently when small barrel hysteroscopes are used, both in operative outpatient procedures and when small barrel resectoscopes are used. The procedure in general has a low risk of adverse effects with an incidence of 0.28% in 13,600 procedures. Indications for endoscopic surgery become wider therefore safety protocols become more important in the prevention of complications. This is particularly important as most complications do occur during the learning curve of the surgeons mastering the technique and in specific procedures, i.e. hysteroscopic myomectomy, where the risk of complications can be as high as 10%. The recommendation is also for hysteroscopic surgery to be graded according to the difficulty. In this chapter, we will discuss on the major and minor complications of hysteroscopic surgery, illustrating by figures and images and discussing on the solutions to reduce and treat complications.