Complications associated with the absorption of hysteroscopic fluid media

C. A. Witz, K. M. Silverberg, W. N. Burns, Robert S Schenken, D. L. Olive

Research output: Contribution to journalArticle

84 Citations (Scopus)

Abstract

Objectives: To review the literature concerning complications resulting from absorption of hysteroscopic fluid distension media and to describe methods to treat and prevent these complications. Design: All pertinent literature on fluid distension media used for endoscopy, as well as relevant reports concerning the management of fluid and electrolyte imbalance, was reviewed. Results: The absorption of large volumes of electrolyte-free, low- viscosity fluid may result in volume overload with water intoxication. Volume overload may cause pulmonary edema, and water intoxication may lead to hyponatremia, hypo-osmolarity, and cerebral edema. In contrast, the absorption of dextran-70 may cause volume overload secondary to the oncotic effect of intravascular dextran. Dextran-70 has been associated with anaphylaxis and coagulation disorders. Treatment: The use of diuretics is advocated. Urine output must be closely monitored. Judicious correction of electrolyte imbalance will prevent morbidity. Prevention: Meticulous attention to intraoperative fluid balance is imperative. A multichannel hysteroscope is necessary to keep intrauterine pressure low. Extensive surgical procedures may need to be performed in stages. Conclusions: Severe volume overload and electrolyte imbalance may result from fluid absorption during operative hysteroscopy. Most complications may be avoided by closely monitoring fluid balance intraoperatively.

Original languageEnglish (US)
Pages (from-to)745-756
Number of pages12
JournalFertility and Sterility
Volume60
Issue number5
StatePublished - 1993

Fingerprint

Electrolytes
Dextrans
Water Intoxication
Water-Electrolyte Balance
Hysteroscopes
Hysteroscopy
Hyponatremia
Brain Edema
Anaphylaxis
Pulmonary Edema
Diuretics
Viscosity
Osmolar Concentration
Endoscopy
Urine
Morbidity
Pressure

Keywords

  • dextran-70
  • distension media
  • glycine
  • Hyskon
  • Hysteroscopy
  • intrauterine surgery

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Witz, C. A., Silverberg, K. M., Burns, W. N., Schenken, R. S., & Olive, D. L. (1993). Complications associated with the absorption of hysteroscopic fluid media. Fertility and Sterility, 60(5), 745-756.

Complications associated with the absorption of hysteroscopic fluid media. / Witz, C. A.; Silverberg, K. M.; Burns, W. N.; Schenken, Robert S; Olive, D. L.

In: Fertility and Sterility, Vol. 60, No. 5, 1993, p. 745-756.

Research output: Contribution to journalArticle

Witz, CA, Silverberg, KM, Burns, WN, Schenken, RS & Olive, DL 1993, 'Complications associated with the absorption of hysteroscopic fluid media', Fertility and Sterility, vol. 60, no. 5, pp. 745-756.
Witz, C. A. ; Silverberg, K. M. ; Burns, W. N. ; Schenken, Robert S ; Olive, D. L. / Complications associated with the absorption of hysteroscopic fluid media. In: Fertility and Sterility. 1993 ; Vol. 60, No. 5. pp. 745-756.
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