Infective complications

Hysteroscopy is considered the gold standard for both diagnosis and treatment of intrauterine pathology. The indications for hysteroscopy include abnormal uterine bleeding, infertility, and Mullerian anomalies. The vagina is naturally colonized by a diverse bacterial flora, and during hysteroscopy, which involves transvaginal and transcervical passage, there is a risk of contamination of the uterine cavity and subsequent infectious pelvic complications. Additionally, the use of irrigation fluids may force the flow through the fallopian tubes and increase the risk of pelvic infection. Although only a few papers in the literature have investigated the risk of infectious complications and the need for antibiotic prophylaxis during hysteroscopy, there is evidence suggesting that such complications are rare. Furthermore, due to the lack of standardized criteria and varying techniques used, the knowledge regarding this topic is limited. However, it is important to recognize that infectious complications can occur within 3weeks after hysteroscopy, and appropriate treatment based on acute pelvic inflammatory disease guidelines should be administered promptly. Nonetheless, based on available evidence, there is no indication for antibiotic prophylaxis for both diagnostic and operative hysteroscopy. © 2024 Elsevier Inc. All rights reserved.