Role of hysteroscopy in evaluating chronic pelvic pain

Objective: To provide a survey of various gynecological conditions causing chronic pelvic pain (CPP) that might be diagnosed by hysteroscopy. Design: Review article. Setting: Departments of obstetrics and gynecology and pathophysiology of human reproduction at a university in Italy. Patient(s): Women affected by CPP. Intervention(s): Hysteroscopy. Main Outcome Measure(s): Effectiveness in diagnosing intrauterine pathologies that cause CPP. Result(s): Hysteroscopy is highly effective in diagnosing various gynecological causes of CPP, including adenomyosis, chronic endometritis, Mullerian anomalies, retained fetal bones, endocervical ossification, and intrauterine abnormalities. Furthermore, hysteroscopy may play a primary role in the resolution of some of these conditions. Conclusion(s): Because it can be executed safely in an office setting without anesthesia, hysteroscopy may be indicated, together with the other noninvasive procedures such as transvaginal ultrasonography, as a first-level investigation in women who are affected by CPP.