BSGE/ESGE guideline on management of fluid distension media in operative hysteroscopy

Umranikar, Sameer; Clark, T. Justin; Sarıdoğan, Ertan; Miligkos, Dimitrios; Arambage, Kirana; Torbé, Emma; Campo, Rudi; Sardo, Attilio Di Spiezio; Tanos, Vasilios; Grimbizis, Grigoris

doi:10.1007/s10397-016-0983-z

Cited by 107 publications

(86 citation statements)

References 62 publications

(74 reference statements)

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“…The effect of temperature of the distending saline has only been evaluated in two studies (with a cumulative total of 164 patients) and these indicated that warm saline did not reduce discomfort during and at the end of the procedure, irrespective of age, menopausal status, parity or type of outpatient hysteroscopy (operative or diagnostic). Neither the Royal College of Obstetricians and Gynecologists' ‘Best Practice in Outpatient Hysteroscopy Green Top Guideline’ nor the European Society of Gynecological Endoscopy's ‘Guideline on Management of Fluid Distension Media in Operative Hysteroscopy’ specify an optimal temperature for outpatient hysteroscopy, probably due to the paucity of objective data. There is also an interesting data from de Freitas Fonseca et al .…”

Section: Discussionmentioning

confidence: 99%

Does temperature of distending medium matter in outpatient hysteroscopy? A double‐blinded cohort control observational study of room temperature versus warmed saline

Kapur

Gruber

Sekar

et al. 2020

J of Obstet and Gynaecol

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Aim There is little data assessing outcomes of outpatient hysteroscopy using warmed versus room temperature saline. The aim of this study was to determine if the temperature of the distending medium during outpatient hysteroscopy affect ease of procedure, clarity of view, procedural discomfort/pain and patient satisfaction. Methods This was a double‐blinded cohort control quasi‐randomized prospective study involving 100 women undergoing outpatient diagnostic and operative hysteroscopy for abnormal uterine bleeding, intrauterine contraceptive devices retrieval and removal of endometrial polyps. Outpatient hysteroscopy was performed either with normal saline either at room temperature (control at 25°C) or warmed to body temperature (37°C). Results Confounding variables such as age, parity, previous cervical surgery, previous vaginal births, menopausal status and indications for hysteroscopy were similar in the room temperature (n = 48) and warmed saline (n = 52) groups. Mean procedure duration (256 vs 233 s), ease of entry (Visual Analogue Scale [VAS] 9.55 vs 9.4) and the clarity of view (VAS 9.02 vs 9.3) were statistically similar in both groups (all P > 0.05) as was discomfort experienced during hysteroscopy (VAS 6.6/10 vs 6.8/10) and at 5 min post‐procedure (VAS 4.2/10 vs 3.2/10) (both P > 0.05). The likelihood of recommending the procedure to a friend was similar in both groups (mean VAS 6.9/10 vs 7.2/10; P = 0.1). Conclusion The temperature of the distension medium did not influence ease of procedure, clarity of hysteroscopy view, procedural discomfort/pain and patient satisfaction. Patients were not any more likely to recommend the procedure to a friend in the warmed saline compared to the room temperature group.

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Section: Discussionmentioning

confidence: 99%

Does temperature of distending medium matter in outpatient hysteroscopy? A double‐blinded cohort control observational study of room temperature versus warmed saline

Kapur

Gruber

Sekar

et al. 2020

J of Obstet and Gynaecol

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“…Clinicians performing these procedures must be familiar with the measures to reduce fluid overload and manage it when it occurs. The guideline group has developed a fluid monitoring chart (details of this chart can be found in the full guideline) that can be used to help prevent and detect excessive vascular absorption of fluid and manage complications arising from this potentially serious complication.…”

Section: Resultsmentioning

confidence: 99%

“…The BSGE/ESGE guideline graded the level of evidence from A to D. Good practice point (GPP) is the recommended best practice based on the clinical experience of the guideline development group. Details of this are in the full guideline …”

Section: Rationale For the Guidelinementioning

confidence: 99%

“…A significant proportion of these serious complications is related to the distension media. To highlight these risks and provide an evidence‐based guidance for the prevention, diagnosis and management of complications arising from excessive absorption of fluid, the British Society for Gynaecological Endoscopy (BSGE), in association with the European Society for Gynaecological Endoscopy (ESGE), has developed a joint guideline on the management of fluid distension media in operative hysteroscopy. This article provides a concise summary of these guidelines.…”

Section: Introductionmentioning

confidence: 99%

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BSGE/ESGE guideline on management of fluid distension media in operative hysteroscopy

Umranikar

Sarıdoğan

Clark

et al. 2018

The Obstetric & Gynaecologis

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Key content Hysteroscopy is a common surgical procedure in gynaecology. Fluid distension media is needed to undertake the procedure. The common fluid distension media available are discussed, along with their properties and role in undertaking operative hysteroscopic procedures. Some inherent complications can occur when there is excessive fluid absorption during hysteroscopic procedures. The monitoring of the fluid distension medium used and how to avoid complications is discussed. Learning objectives To gain a better understanding of the fluid media are available for hysteroscopic surgery. To understand the risks associated with the use of different distension fluid media. To understand the difference between the various fluid distension media and their effect when excessive absorption occurs. To recognise, manage and prevent complications associated with excessive fluid absorption. To understand the different monitoring systems available during surgery.

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“…Patients who develop fluid overload will experience headache or drowsiness, convulsions or apnea, or vomiting [8,18]. The occurrence of such symptoms, even without reaching the fluid limits, requires additional diagnostic tests and should be treated as a complication [37].…”

Section: Venous Intravasation/operative Hysteroscopy Intravascular Abmentioning

confidence: 99%

Complications in modern hysteroscopic myomectomy

Ciebiera

Łoziński²,

Wojtyła

et al. 2018

Ginekol Pol

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Uterine fibroids (UFs) are common benign tumors of the female genital tract, diagnosed in almost one-quarter of women of reproductive age. UFs may cause numerous clinical symptoms, including prolonged or heavy menstrual bleeding, pelvic pressure symptoms, pain, infertility and others. Submucous fibroids arise from the muscular part of the uterus and pen-etrate into the uterine cavity. They are mostly managed with the use of hysteroscopic myomectomy (HM), which provides direct visualization from the transcervical approach. The sheer number of HM standards and techniques is reason enough to review the available literature about HM-related complications. HM is a safe and effective treatment in patients with the normal size of the uterus and with no more than a few UFs. The procedure should not be initiated without adequate preparation and diagnosis, using the best methods available.

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BSGE/ESGE guideline on management of fluid distension media in operative hysteroscopy

Cited by 107 publications

References 62 publications

Does temperature of distending medium matter in outpatient hysteroscopy? A double‐blinded cohort control observational study of room temperature versus warmed saline

Does temperature of distending medium matter in outpatient hysteroscopy? A double‐blinded cohort control observational study of room temperature versus warmed saline

BSGE/ESGE guideline on management of fluid distension media in operative hysteroscopy

Complications in modern hysteroscopic myomectomy

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