This protocol applies to premenopausal women of reproductive age with cervical stricture or stenosis who require access to the uterine cavity but have not achieved sufficient cervical canal patency through standard preprocedural ripening.
Preprocedural cervical ripening — using misoprostol, laminaria osmotic dilators, or dinoprostone — did not restore the patency of the cervical canal to a degree allowing cervical dilation. This protocol defines the mechanical next step taken after that failure.
The next step centres on mechanical cervical dilation using specialised graduated dilators. An adjunctive agent may be administered directly at the cervix immediately before the procedure to facilitate entry under specific monitoring conditions. The full selection criteria, procedural sequence, and safeguards are in the complete protocol.
Restoration of the patency of the cervical canal, allowing entry into the uterine cavity.