Hysteroscopic evaluation and analysis of uterine cavity: a retrospective institutional study

Background: Hysteroscopy provides direct visualization of the cervical canal and uterine cavity and is widely used for the diagnosis and management of intrauterine abnormalities. It allows identification of lesions such as endometrial polyps, submucosal fibroids, uterine septa, and endometrial hyperplasia, with the advantage of permitting therapeutic intervention when indicated. Objective was to evaluate the hysteroscopic findings among patients undergoing diagnostic or operative hysteroscopy and to assess their relationship with clinical presentation, ultrasonographic findings, and histopathological outcomes. Methods: This retrospective observational study was conducted in the department of gynecology and obstetrics, Holy Family Red Crescent Medical College and Hospital (HFRCMCH), from July 2024 to June 2026. A total of 32 patients who underwent rigid hysteroscopy were included. Normal saline was used as the uterine distension medium. Data regarding demographic characteristics, clinical indications, ultrasonographic findings, hysteroscopic findings, histopathological results, and procedure-related complications were retrieved from the medical records and analyzed. Results: Among the 32 patients who underwent hysteroscopy, abnormal intrauterine findings were identified in 29 (90.6%) cases. The largest proportion of patients belonged to the 41-50-year age group (31.3%), and 93.8% were multiparous. Postmenopausal bleeding was the most common indication for hysteroscopy (34.38%). Endometrial polyps were the most frequently identified hysteroscopic abnormality (34.38%). No procedure-related complications were documented during the study period. Conclusions: In this institutional series, hysteroscopy identified intrauterine abnormalities in the majority of patients and was performed without documented procedure-related complications. The findings support its clinical utility as a minimally invasive method for direct assessment of the uterine cavity in appropriately selected patients.