Hysteroscopy and hysterography.

Hysteroscopy and hysterography approach the uterine cavity in different ways and each has advantages and limitations. Hysteroscopy is more accurate for the diagnosis of abnormalities that project into the uterine cavity such as polyps, submucous myomas, endometrial hyperplasia, and endometrial adenocarcinoma. Contrast media used in hysterography enable the detection of lesions that penetrate the myometrium and congenital and acquired partitions of the uterine cavity. Diagnostic hysteroscopy, easily performed as an office procedure, should be the screening method of choice to search for uterine abnormalities except for the infertility patient who also requires a salpingogram. Hysterography should be considered as a complementary procedure only when the direct visual examination proves incomplete or inadequate. It is necessary for a thorough assessment of uterine malformations, adenomyosis, complex intrauterine adhesions, and uterine scars.