Hemorrhage risk during operative hysteroscopy

Agostini, Aubert; Cravello, L.; Desbrière, Raoul; Maisonneuve, Anne Sophie; Roger, V.; Blanc, B.

doi:10.1034/j.1600-0412.2002.810914.x

Cited by 32 publications

(19 citation statements)

References 12 publications

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“…52 Another approach to the management of intracavitary bleeding recognized at the end of a procedure (often secondary to the loss of intrauterine tamponade effect from the distending media) is the inflation of a 30-mL Foley catheter balloon or similar tamponade device. 80 Such balloons can easily and safely be inflated to 50 mL if deemed necessary.…”

Section: Prevention Recognition and Managementmentioning

confidence: 99%

Complications of Hysteroscopic and Uterine Resectoscopic Surgery

Munro

Christianson

2015

Clinical Obstetrics &Amp; Gynecology

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Adverse events associated with hysteroscopic procedures are generally rare, but, with increasing operative complexity, it is now apparent that they are experienced more often. There exists a spectrum of complications that relate to generic components of procedures, such as patient positioning, anesthesia, and analgesia, to a number that are specific to intraluminal endoscopic surgery that largely comprise perforation and injuries to surrounding structures and blood vessels. Whereas a number of endoscopic procedures require the use of distending media, the response of premenopausal women to excessive absorption of nonionic fluids used for hysteroscopy is somewhat unique, and deserves special attention on the part the surgeon. There is also an increasing awareness of uncommon but problematic sequelae related to the use of monopolar radiofrequency uterine resectoscopes that involve thermal injury to the vulva and vagina. Furthermore, the uterus that has previously undergone hysteroscopic surgery may behave in unusual ways, at least in premenopausal women who experience menstruation or who become pregnant. Fortunately, better understanding of the mechanisms involved in these adverse events, as well as the use or development of a number of innovative devices, have collectively provided the opportunity to perform hysteroscopic and resectoscopic surgery in a manner that minimizes risk to the patient.

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Section: Prevention Recognition and Managementmentioning

confidence: 99%

Complications of Hysteroscopic and Uterine Resectoscopic Surgery

Munro

Christianson

2015

Clinical Obstetrics &Amp; Gynecology

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“…Hemorrhage during hysteroscopy can occur at a general rate of 0.16% 2 and is related to the type of the operating procedure 5 . The risk for hemorrhage is reported higher during hysteroscopic adhesiolysis (2.51%) in comparison to other procedures like endometrial ablation (0.48%), polyp resection (0.47%), myoma resection (0.37%), and uterine septae ablation (0%) 5 .…”

Section: Procedure‐related Complicationsmentioning

confidence: 99%

Safety Issues of Hysteroscopic Surgery

Paschopoulos

Polyzos

Lavasidis

et al. 2006

Annals of the New York Academy of Sciences

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The term hysteroscopy is used to determine the procedure during which an endoscopic view of the endometrial cavity is achieved with the help of a type of endoscopic device called "the hysteroscope." Hysteroscopy is used to assist the diagnosis for a series of female pathology. Apart from its diagnostic value, hysteroscopy can also be used for operative procedures including ablation and resection. Both diagnostic and operative hysteroscopy have been used for a number of years and various studies have been published to describe their success and complication rates throughout this period. Diagnostic hysteroscopy is relatively safe, whereas complications occur more frequently when operative hysteroscopy is used. These complications include uterine perforation, hemorrhage, fluid overload, gas embolization, and hyponatremia. The rate in the appearance of these complications is dependent on the type of the hysteroscopic procedure, the distending medium, and the experience of the hysteroscopist. To avoid any problems concerning the application of hysteroscopic procedures, it is important to take the necessary precautions both preoperatively and intraoperatively. For example, the preoperative use of thinning agents of the endometrium and the reduction of the operating time, or the avoidance of cutting too deeply into the myometrium, are some of the parameters to be considered when hysteroscopy is in argument.

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“…If the deficit thresholds are met but ongoing bleeding is encountered, the surgeon should avoid continuing the procedure just to achieve hemostasis e this can usually be managed by removing the resectoscope and inserting a Foley catheter into the cavity to provide tamponade. The catheter can often be removed 6e12 h after the procedure [27]. It is important to recognize the potential for "fixation error" in these circumstances e the temptation is to continue the operation for a few more minutes to treat the small "bleeder."…”

Section: Minimizing Absorptionmentioning

confidence: 99%