A uterine treatment device, comprising: a shaft sized and configured for insertion into a uterus of a patient; a sealing balloon disposed on the shaft and for sealing the uterus; inflow and outflow lumens (129, 131) disposed along a length of the shaft; at least one inflow port disposed at a distal end of the inflow lumen; at least one outflow port disposed at a distal end of the outflow lumen; a gas/fluid source operatively coupled to the inflow and outflow lumens; at least one flow meter disposed between the gas/fluid source and the shaft; and a controller configured to perform a uterine integrity test by delivering gas or fluid from the gas/fluid source through the at least one inflow lumen into the uterus without allowing for gas or fluid to be removed from the uterus, detecting with the at least one flow meter an integrity flow rate of gas or fluid as it is delivered into the uterus, and determining that the uterus is sealed if the integrity flow rate decreases below an integrity flow rate threshold value; the controller further configured to determine that the uterus has a perforation that is sealed at lower pressures and is opened at higher pressures if the integrity flow rate oscillates between a low level and a high level; the controller also configured to, if it is determined that the uterus is sealed, deliver gas or fluid through the at least one inflow lumen into the uterus, remove gas or fluid from the uterus with the outflow lumen, detect with the at least one flow meter a patency flow rate of gas or fluid, and determine whether the uterine treatment device is clogged or embedded in tissue based on the patency flow rate. a shaft sized and configured for insertion into a uterus of a patient; a sealing balloon disposed on the shaft and for sealing the uterus; inflow and outflow lumens (129, 131) disposed along a length of the shaft; at least one inflow port disposed at a distal end of the inflow lumen; at least one outflow port disposed at a distal end of the outflow lumen; a gas/fluid source operatively coupled to the inflow and outflow lumens; at least one flow meter disposed between the gas/fluid source and the shaft; and a controller configured to perform a uterine integrity test by delivering gas or fluid from the gas/fluid source through the at least one inflow lumen into the uterus without allowing for gas or fluid to be removed from the uterus, detecting with the at least one flow meter an integrity flow rate of gas or fluid as it is delivered into the uterus, and determining that the uterus is sealed if the integrity flow rate decreases below an integrity flow rate threshold value; the controller further configured to determine that the uterus has a perforation that is sealed at lower pressures and is opened at higher pressures if the integrity flow rate oscillates between a low level and a high level; the controller also configured to, if it is determined that the uterus is sealed, deliver gas or fluid through the at least one inflow lumen into the uterus, remove gas or fluid from the uterus with the outflow lumen, detect with the at least one flow meter a patency flow rate of gas or fluid, and determine whether the uterine treatment device is clogged or embedded in tissue based on the patency flow rate.