Hysteroscopy using a CO2 tubal insufflator without the vacuum cannula.

The CO2 tubal insufflator delivers CO2 at 30 ml. per minute at pressure not exceeding 150 mm. of Hg. The vacuum cannula is not used. Any leakage of gas is controlled by applying a Vulsellum laterally. 78 Hysteroscopies were done using this technique. The procedure was unsatisfactory in 4 cases (5.1%). Out of 61 (78.2%) cases of infertility, there was some pathology in 35 (57.4%) cases. Out of 8 (10.2%) cases of menometrorrhagia, 6 (75%) had polypoidal endometrium, localised or diffuse and 1 (12.5%) had a fibroid. 1 (1.3%) case of postmenopausal bleeding had an endometrial polyp, which was removed. Of the 5 (6.4%) cases of amenorrhea, 4 (80%) had synechia which could be divided. 1 (1.3%) case of dysmenorrhoea had an endometrial polyp which was removed. 2 (2.6%) Lost IUDs were also removed. Operative hysteroscopy was done in 13 (16.6%) cases; removal of lost IUD--2 cases (15.4%); removal of endometrial polyp--4 cases (30.8%); division of synechiae--6 cases (46.1%) and division of septum--1 case (7.7%). Hysteroscopy was useful in diagnosing pathology in 64% of cases and treating them in 16.6% cases.