In 1869, a hemorrhagic uterine growth was diagnosed and cauterized with silver nitrate, thus qualifying the procedure to be the first operative hysteroscopy during direct visualization of endometrial cavity. The pressure required to separate the walls of a normal-sized uterine cavity (with saline) is less than 50mmHg. A solution containing 35% dextran 70 (molecular weight 70,000 kDa) was introduced as a distending medium for hysteroscopy. Compared with placebo, use of misoprostol among premenopausal women before hysteroscopy was found to result in fewer cervical lacerations, most probably secondary to a reduced need for cervical dilation. Despite the increasing adoption of hysteroscopy as an ambulatory procedure, protocols for local anesthesia and/or analgesia remain far from uniform. In a flexible hysteroscope, fiberoptic bundles (flexible) transmit the image to the eyepiece or the camera. Pregnancy and genital tract infections are obvious contraindications to hysteroscopy.