Complications of Hysteroscopy
- 1 August 2000
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Obstetrics & Gynecology
- Vol. 96 (2), 266-270
- https://doi.org/10.1097/00006250-200008000-00021
Abstract
Objective To estimate the incidence of complications of diagnostic and operative hysteroscopic procedures in the Netherlands and describe their nature. Methods Data on complications were recorded by 82 hospitals in 1997. Participating hospitals had a 100% response rate. Any unexpected events that required intraoperative or postoperative intervention were defined as complications in two groups: approach (entry-related) and technique-related (caused by surgical instruments). Results Thirty-eight complications occurred among 13,600 hysteroscopic procedures (rate 0.28%). Diagnostic hysteroscopic procedures had a significantly lower complication rate (0.13%) than operative procedures (rate 0.95%; P < .01). Fluid overloads of distention medium were recorded five times (rate 0.20%). The most frequent surgical complication was perforation of the uterine cavity (rate 0.76%). Approximately half the perforations (18 of 33) were entry-related. Bleeding caused by perforation was seen in 0.16% of cases. Incidences of complications were: intrauterine adhesiolysis 4.48%, endometrium resection 0.81%, myomectomy 0.75%, and removal of a polyp 0.38%. Conclusion Diagnostic hysteroscopic procedures had very low complication rates, so are safe procedures with which to evaluate intrauterine pathology. Operative hysteroscopic procedures were more risky, but the removal of polyps had a very low complication rate (12 times lower than synechiolysis). Half the complications were entry-related, so attention has to be paid to the method of entry with the hysteroscope (ie, no unnecessary dilation of cervix and introduction of the scope under direct vision). The other half of complications were related to surgeons' experience and type of procedure.Keywords
This publication has 13 references indexed in Scilit:
- Medical Research Council randomised trial of endometrial resection versus hysterectomy in management of menorrhagiaThe Lancet, 1997
- Fatal infection following transvaginal fibroid resectionGynaecological Endoscopy, 1996
- Endometrial Resection for the Treatment of MenorrhagiaThe New England Journal of Medicine, 1996
- Good practice with endometrial ablationObstetrics & Gynecology, 1995
- A Scottish audit of hysteroscopic surgery for menorrhagia: complications and follow upBJOG: An International Journal of Obstetrics and Gynaecology, 1995
- Randomised trial of hysterectomy, endometrial laser ablation, and transcervical endometrial resection for dysfunctional uterine bleedingBMJ, 1994
- Hysteroscopy: An evolving case of minimally invasive therapy in gynaecologyHealth Policy, 1993
- Intrauterine pressure and fluid absorption during continuous flow hysteroscopyAmerican Journal of Obstetrics and Gynecology, 1992
- Experience with the first 250 eridometrial resections for menorrhagiaThe Lancet, 1991
- Disseminated intravascular coagulopathy and adult respiratory distress syndrome: Life-threatening complications of hysteroscopyAmerican Journal of Obstetrics and Gynecology, 1990