Background: Hysteroscopy is a cornerstone for diagnosing and treating intrauterine pathologies, yet data from secondary maternity settings are limited.
Objective: To describe the indications, findings, interventions, and complications of diagnostic and operative hysteroscopy in a secondary maternity hospital.
Methods: A retrospective study of 332 women undergoing hysteroscopy at Menzel Temim Regional Hospital (level IIB) from January 2018 to December 2020. Data on demographics, indications, imaging, hysteroscopic findings, interventions, and complications were extracted from medical records. Descriptive statistics summarized outcomes.
Results: Mean age was 46.9 ± 9.8 years; 48.6% were premenopausal. Abnormal uterine bleeding (AUB) was the primary indication (48.2%), followed by pelvic pain (27.5%) and infertility (12.7%). Diagnostic hysteroscopy (90.4%) identified endometrial hypertrophy (20.2%), polyps (18.4%), and fibroids (7.8%); 12.6% were normal or inconclusive. Operative hysteroscopy (27.4%) included polypectomy (10.9%), myomectomy (4.8%), and adhesiolysis (3.0%). Complications occurred in 4%, including uterine perforation (1.5%) and hemorrhage (0.6%). General anesthesia was used in 84.6%, and saline irrigation in 89.8%. No TURP syndrome was reported.
Conclusion: Hysteroscopy effectively diagnosed and managed intrauterine pathologies in a secondary setting, with AUB driving most procedures and low complication rates. Integrating ultrasound guidance and local anesthesia could enhance outcomes.