[Clinical study of severe complications during hysteroscopic surgeries].

Abstract

To investigate the clinical characteristics, treatment and prevention methods of severe complications during hysteroscopic procedures. From January 1995 to January 2001, seventeen cases with uterine perforation, heavy bleeding and fluid overload respectively were encountered during hysteroscopic procedures. This analysis focuses on their diagnosis and clinical management as well as prevention methods. Three cases with uterine perforation and seven with incomplete perforation followed transcervical resection of myoma (TCRM), transcervical resection of adhesion, transcervical resection of septum and transcervical removal of foreign body respectively, which were diagnosed by both B ultrasonography and laparoscopy and treated laparoscopically. Four cases with heavy bleeding were encountered during TCRM. Foley catheter was inserted into uterine cavity to stop the bleeding successfully. Three cases with fluid overload were cured by diuretic agent and saline infusion. There were no serious consequence happened. It is a potential high risk factor of resulting in complications that performing complicated procedures inside uterine cavity during hysteroscopic operations. Pre-treatment with gonadotropin-releasing-a and guiding with B ultrasound/laparoscopy as well as controlling irrigation pressure are necessary for preventing above complications.