Distending media for hysteroscopy

Hysteroscopy was first performed in 1869 by Pantaleoni; his use of an endoscope to observe polyps in the uterus was probably the first type of endoscopy used in gynecology. However, other forms of endoscopy such as laparoscopy have gained wider acceptance and applications over the years than has hysteroscopy because of the lack of effective uterine distending media that would make panoramic hysteroscopy both possible and practical. The uterine cavity constitutes a potential space that can be created by distention. Rubin first introduced the use of carbon dioxide (CO₂) gas as a distending agent. Agents that have since been utilized frequently are dextran 70 (Hyskon) and low-viscosity fluids. In this article, we will discuss the different techniques for uterine distention in panoramic hysteroscopy and their advantages and disadvantages.