The role of antibiotic therapy and hysteroscopy technique in the prevention of infectious and inflammatory complications

Inflammatory complications are relatively frequent in the hierarchy of complications of hysteroscopy. The article describes two clinical case scenarios of hysteroscopic procedures complicated by pelvioperitonitis. The analysis of contemporary local and international literature is presented, and shows different attitude towards the antibiotic prophylaxis of inflammatory complications related to hysteroscopy. Taking into account that potential spread of infected material from the uterine cavity through the tubes into Douglas space plays role in the pathogenesis of inflammatory complications, it is advisable to consider the value of intra-uterine pressure as one of the main factors responsible for the development of inflammatory complications. It is also prudent to use the technique and values of in-office hysteroscopy to prevent tubal reflux and thus reduce the chance of infectious complications. The possibility of complete abandonment of antibiotic prophylaxis requires additional research and confirmation with clinical studies.