Diagnostic hysteroscopy 

Dr Castellacci was able to specialise in hysteroscopy during a period of technological development that enabled gynaecologists to expand their knowledge and propose a minimally invasive approach to uterine pathologies that allows them to treat and resolve a large proportion of uterine problems through a natural access route, often without the need for sedation.

Hysteroscopy is a diagnostic and therapeutic method at the service of the patient and gynaecology. It has established itself in recent years thanks to a sophisticated technological evolution, which has allowed it to be used in outpatient settings. Thanks to this technique, diagnostic uses of the endometrial cavity have been made, as well as therapeutic uses, both in the field of infertility and cancer prevention, benign endocavitary pathology, and uterine malformative pathology.

Diagnostic Hysteroscopy represents a minimally invasive gynaecological endoscopic investigation which, through the use of a very thin camera lens and appropriate instruments, allows a clear direct view of the uterine cavity and the cervical canal, permitting an accurate diagnosis of uterine pathologies in both fertile and menopausal age. The hysteroscopic examination can always be performed while in the fertile age it is preferable to perform it in the immediate post-menstrual phase because the endometrium is more unloaded and therefore more visible inside and above all because in this phase there are no risks for conception.

The use of truly miniaturised instruments in the order of 3.5 mm or 5.0 mm, together with today's use of physiological saline solution (water) instead of gas to obtain optimal distension of the tissues of the uterine cavity allows us to affirm that diagnostic and office hysteroscopy is truly a non-invasive but decisive micro-surgery for many pathologies in full respect of the woman's psychophysical well-being. 

Abnormal uterine bleeding refers to abnormal bleeding from the uterus, which may occur with intermenstrual bleeding (spotting - metrorrhagia) or with bleeding greater than 80 ml. per cycle (menorrhagia).

Organic causes leading to uterine bleeding can be

• uterine polyps (cervical - endometrial)
• uterine myomas
• adenomyosis or uterine endometriosis
• endouterine devices (IUD)
• isthmocele (complication of caesarean sections)
• endometrial hyperplasia 
• neoplasms of the endometrium
  

Today, hysteroscopy is the standard of excellence in close synergy with transvaginal ultrasound.