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As in the case of any surgery, hysteroscopic surgery carries certain risks, but complications are relatively uncommon (see table).

After Jansen et al. Complications of Hysteroscopy: A Prospective, Multicenter Study. Obstetrics and Gynecologyl 2000;96:266–70.

The three most serious complications are uterine perforation, fluid overload and haemorrhage. If the uterus is perforated, there is a risk of injury to intra-abdominal structures such as bowel, bladder and even large blood vessels, and it is for this reason that a laparoscopy or even a laparotomy may be required. Fluid overload is largely avoidable by carefully monitoring fluid balance during surgery, and it it does occur, is managed with diuretics. Haemorrhage is only a risk with prolonged extensive surgery extending deep into the myometrium (muscle of the womb) such as when removing a large submucous fibroid.

Other risks include infection and air embolism, but the incidence is also low.