Skip to main content
SpringerLink
Log in
Book cover

Manual of Fertility Enhancing Hysteroscopy pp 179–190Cite as

Complications of Hysteroscopy

  • Chapter
  • First Online:

Abstract

Surgeries of the uterine cavity can be expedited by the minimally invasive route with the availability of hysteroscopic techniques. Procedures like myomectomy, endometrial ablation, synechiolysis, removal of displaced intrauterine devices and removal of foreign bodies and products of conception can be done without the need for major surgery via the hysteroscopic route. Hysteroscopic procedures are generally regarded safe and are not associated with any major complications. However life-threatening fluid overload and electrolyte imbalance can result inherent to the properties of distention media being used. It is necessary therefore to be vigilant and conversant with fluid management systems. It is imperative for the new age gynaecologist to be mindful of the complications that can arise and be able to prevent them from occurring and manage them proficiently. Whoever has dealt with hysteroscopy intravasation syndrome knows fully well the meaning of the quote by Benjamin Franklin “an ounce of prevention is worth a pound of cure.”

In this chapter we outline the complications both common and rare and the ways to avoid them and confront them if and when they arise.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   119.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Mettler L, Patel P, Caballero R, Schollmeyer T. Hysteroscopy: an analysis of 2-years’ experience. JSLS. 2002;6(3):195–7.

    CAS  PubMed  PubMed Central  Google Scholar 

  2. Jansen FW, Vredevoogd CB, van Ulzen K, Hermans Trimbos J. Complications of hysteroscopy: a prospective, multicenter study. Obstet Gynecol. 2000;96(2):266–70.

    CAS  Google Scholar 

  3. Cayuela E, Cos R, Onbargi L, et al. Complications of operative hysteroscopy. J Am Assoc Gynecol Laparosc. 1996;3(suppl 4):s6.

    Article  CAS  Google Scholar 

  4. Hulka JF, Peterson HA, Phillips JM, Surrey M. Operative hysteroscopy: American Association of Gynecology membership survey. J Am Assoc Laparosc. 1995;2(1995):131–2.

    Article  CAS  Google Scholar 

  5. Propst AM, Liberman RF, Hodow BL, Ginsburg ES. Complications of hysteroscopic surgery: predicting patients at risk. Obstet Gynecol. 2000;96(4):517–20.

    CAS  PubMed  Google Scholar 

  6. Warner MA, Martin JT, Schroeder DR, Offord KP, Chute CG. Lower-extremity motor neuropathy associated with surgery performed on patients in a lithotomy position. Anesthesiology. 1994;81(1):6–12.

    Article  CAS  Google Scholar 

  7. Cannì M, Gallia L, Fanzago E, Bocci F, Bertini U, Barbero M. Day-surgery operative hysteroscopy with loco-regional anesthesia. Minerva Ginecol. 2001;53(5):307–11.

    PubMed  Google Scholar 

  8. Mushambi MC, Williamson K. Anaesthetic considerations for hysteroscopic surgery. Best Pract Res Clin Anaesthesiol. 2002;16(1):35–52.

    Article  Google Scholar 

  9. Aydeniz B, Gruber IV, Schauf B, Kurek R, Meyer A, Wallwiener D. A multicenter survey of complications associated with 21,676 operative hysteroscopies. Eur J Obstet Gynecol Reprod Biol. 2002;104(2):160–4.

    Article  CAS  Google Scholar 

  10. Brusco GF, Arena S, Angelini A. Use of carbon dioxide versus normal saline for diagnostic hysteroscopy. Fertil Steril. 2003;79:993–7.

    Article  Google Scholar 

  11. Pellicano M, Guida M, Zullo F, Lavitola G, Cirillo D, Nappi C. Carbon dioxide versus normal saline as a uterine distension medium for diagnostic vaginoscopic hysteroscopy in infertile patients: a prospective, randomized, multicenter study. Fertil Steril. 2003;79:418–21.

    Article  Google Scholar 

  12. Corson SL, Brooks PG, Soderstrom RM. Gynecologic endoscopic gas embolism. Fertil Steril. 1996;65:529–53.

    Article  CAS  Google Scholar 

  13. Paull J. A prospective study of dextran-induced anaphylactoid reactions in 5745 patients. Anaesth Intensive Care. 1987;15:163–7.

    CAS  PubMed  Google Scholar 

  14. Berg A, Sandvik L, Langebrekke A, Istre O. A randomized trial comparing monopolar electrodes using glycine 1.5% with two different types of bipolar electrodes (TCRis, Versapoint) using saline, in hysteroscopic surgery. Fertil Steril. 2009;91:1273–8.

    Article  Google Scholar 

  15. Darwish AM, Hassan ZZ, Attia AM, Abdelraheem SS, Ahmed YM. Biological effects of distension media in bipolar versus monopolar resectoscopic myomectomy: a randomized trial. J Obstet Gynaecol Res. 2010;36:810–7.

    Article  Google Scholar 

  16. Ayus JC, Arieff AI. Glycine-induced hypo-osmolar hyponatremia. Arch Intern Med. 1997;157:223–6.

    Article  CAS  Google Scholar 

  17. Ayus JC, Wheeler JM, Arieff AI. Postoperative hyponatremic encephalopathy in menstruant women. Ann Intern Med. 1992;117:891–7.

    Article  CAS  Google Scholar 

  18. Wegmüller B, Buenzli HCM, Yuen B, Maggiorini M, Rudiger A. Life-threatening laryngeal edema and hyponatremia during hysteroscopy. Crit Care Res Prac. 2011;2011:1403814 pages. https://doi.org/10.1155/2011/140381.

    Article  Google Scholar 

  19. Sethi N, Chaturvedi R, Kumar K. Operative hysteroscopy intravascular absorption syndrome: a bolt from the blue. Indian J Anaesth. 2012;56(2):179–82.

    Article  Google Scholar 

  20. Lee GY, In Han J, Heo HJ. Severe hypocalcemia caused by absorption of sorbitol-mannitol solution during hysteroscopy. J Korean Med Sci. 2009;24:532–4.

    Article  Google Scholar 

  21. Hasham F, Garry R, Kokri MS, Mooney P. Fluid absorption during laser ablation of the endometrium in the treatment of menorrhagia. Br J Anaesth. 1992;68:151–4.

    Article  CAS  Google Scholar 

  22. Garry R, Hasham F, Manhoman SK, Mooney P. The effect of pressure on fluid absorption during endometrial ablation. J Gynecol Surg. 1992;8:1–10.

    Article  Google Scholar 

  23. Boyd HR, Stanley C. Sources of error when tracking irrigation fluids during hysteroscopic procedures. J Am Assoc Gynecol Laparosc. 2000;7:472–6.

    Article  CAS  Google Scholar 

  24. Mavrelos D, Ben-Nagi J, Davies A, Lee C, Salim R, Jurkovic D. The value of pre-operative treatment with GnRH analogues in women with submucous fibroids: a double-blind, placebo-controlled randomized trial. Hum Reprod. 2010;25(9):2264–9.

    Article  CAS  Google Scholar 

  25. Phillips DR, Nathanson HG, Milim SJ, Haselkorn JS, Khapra A, Ross PL. The effect of dilute vasopressin solution on blood loss during operative hysteroscopy: a randomized controlled trial. Obstet Gynecol. 1996;88:761–6.

    Article  CAS  Google Scholar 

  26. Baskett TF, Farrell SA, Zilbert AW. Uterine fluid irrigation and absorption in hysteroscopic endometrial ablation. Obstet Gynecol. 1998;92:976–8.

    CAS  PubMed  Google Scholar 

  27. van Dongen H, Emanuel MH, Wolterbeek R, Trimbos JB, Jansen FW. Hysteroscopic morcellator for removal of intrauterine polyps and myomas: a randomized controlled pilot study among residents in training. J Minim Invasive Gynecol. 2008;15:466–71.

    Article  Google Scholar 

  28. Kumar A, Kumar A. A simple technique to reduce fluid intravasation during endometrial resection. J Am Assoc Gynecol Laparosc. 2004;11:83–5.

    Article  CAS  Google Scholar 

  29. Istre O, Bjoennes J, Naess R, Hornbaek K, Forman A. Postoperative cerebral oedema after transcervical endometrial resection and uterine irrigation with 1.5% glycine. Lancet. 1994;344:1187–9.

    Article  CAS  Google Scholar 

  30. Wood SM, Roberts FL. Air embolism during transcervical resection of endometrium. BMJ. 1990;300(6729):945.

    Article  CAS  Google Scholar 

  31. Shaikh N, Ummunisa F. Acute management of vascular air embolism. J Emerg Trauma Shock. 2009;2(3):180–5.

    Article  Google Scholar 

  32. Stankova T, Ganovska A, Stoianova M, Kovachev S. Complication of diagnostic and operative hysteroscopy- review. Akush Ginekol (Sofiia). 2015;54(8):21–7.

    CAS  Google Scholar 

  33. Corson SL. Hysteroscopic diagnosis and operative therapy of submucous myoma. Obstet Gynecol Clin North Am. 1995;22:739–55.

    CAS  PubMed  Google Scholar 

  34. Howe RS. Third trimester uterine rupture following hysteroscopic uterine perforation. Obstet Gynecol. 1995;7:311–6.

    Google Scholar 

  35. Bellingham R. Intrauterine adhesions: hysteroscopic lysis and adjunctive methods. Aust NZ Obstet Gynaecol. 1996;36:171–4.

    Article  CAS  Google Scholar 

  36. Hart R, Molnar Béla G, Magos A. Long term follow up of hysteroscopic myomectomy assessed by survival analysis. Br J Obstet Gynaecol. 1999;106:700–5.

    Article  CAS  Google Scholar 

  37. Parkin DE. Fatal toxic shock syndrome following endometrial resection. Br J Obstet Gynecol. 1995;102:163–4.

    Article  CAS  Google Scholar 

  38. Raiga J, Bowen J, Glowaczower E, et al. Failure factors in endometrial resection 196 cases. J Gynecol Obstet Biol Reprod (Paris). 1994;23:274–8.

    CAS  Google Scholar 

  39. Reed H, Callen PJ. Myometrial leiomyosarcoma following transcervical resection of the endometrium. Gynecol Endosc. 1996;5:49–50.

    Article  Google Scholar 

  40. Indman PD. Hysteroscopic treatment of menorrhagia associated with uterine leiomyomas. Obstet Gynecol. 1993;81:716–20.

    CAS  PubMed  Google Scholar 

  41. Neuwirth RS. Hysteroscopic submucous myomectomy. Obstet Gynecol Clin North Am. 1995;22:541–58.

    CAS  PubMed  Google Scholar 

  42. Cararach M, Penella J, Ubeda A, Labastida R. Hysteroscopic incision of the septate uterus: scissors versus resectoscope. Hum Reprod. 1994;9:87–9.

    Article  CAS  Google Scholar 

  43. Vercellini P, Fedele L, Arcaini L, Rognoni MT, Candiani GB. Value of intrauterine device insertion and estrogen administration after hysteroscopic metroplasty. J Reprod Med. 1989;34:447–50.

    CAS  PubMed  Google Scholar 

  44. Abu Rafea BF, Vilos GA, Oraif AM, Power SG, Cains JH, Vilos AG. Fertility and pregnancy outcomes following resectoscopic septum division with and without intrauterine balloon stenting: a randomized pilot study. Ann Saudi Med. 2013;33:34–9.

    Article  Google Scholar 

  45. Sentilhes L, Sergent F, Roman H, Verspyck E, Marpeau L. Late complications of operative hysteroscopy: predicting patients at risk of uterine rupture during subsequent pregnancy. Eur J Obstet Gynecol Reprod Biol. 2005;120(2):134–8.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Milann Kumarapark, Bengaluru, Karnataka, India

    Shruti Gupta MD (AIIMS), DNB, FNB

Authors
  1. Shruti Gupta MD (AIIMS), DNB, FNB
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Director and Senior Consultant, Reproductive Medicine, Dreamz IVF, New Delhi, India

    Shikha Jain

  2. Consultant Reproductive Medicine and Assistant Professor (Dept of OBGY), Bharati Vidyapeeth (Deemed to be University) Medical College, Pune, Maharashtra, India

    Dattaprasad B. Inamdar

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Gupta, S. (2018). Complications of Hysteroscopy. In: Jain, S., Inamdar, D. (eds) Manual of Fertility Enhancing Hysteroscopy. Springer, Singapore. https://doi.org/10.1007/978-981-10-8028-9_12

Download citation

  • DOI: https://doi.org/10.1007/978-981-10-8028-9_12

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-10-8027-2

  • Online ISBN: 978-981-10-8028-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation