IS IT POSSIBLE TO DIAGNOSE EARLY A BEGINN ING FLUID ABSORPTION DURINGOPERATIVE HYSTEROSCOPY BY ADDING ETHANOL TO THE DISTENSION MEDIUM

Objective: Is it possible to diagnose early a beginning fluid absorpti on during operative hysteroscopy by adding ethanol to the distension m edium? Methods: A prospectively randomised comperative study of ablati ve versus non-ablative operative hysteroscopy with differing ethanol c oncentration was performed. Purisole (a mannitol/sorbitol solution) wa s used as distension medium. Results: The results of the study show th at at those hysteroscopical procedures at which the endometrium is not or only minimally injured (e.g. syneciolysis, hysteroscopic proximal tubal catheterisation) an intraoperative screening is not necessary du e to the low absorbing amounts. At the hysteroscopical procedures as t he resection of myoma, endometrium-ablation and septumresection, howev er, an addition of ethanol of 2% to the distension medium has proved t o be useful, because with this method absorbing amounts from 400 mls c an be established by positive values of breath alcohol. As the result of a further absorption of fluid, but delayed in time compared to the first positive value of breath alcohol, there is an increase of the ce ntral venous pressure and a hyponatraemia. Conclusion: The intraoperat ive ethanol-monitoring is a non-invasive procedure which can be perfor med at ablative-operative hysteroscopies and has no negative influence on the course of the intervention and the general condition of the pa tients.