THE USE OF LOW-VISCOSITY FLUIDS FOR HYSTEROSCOPY

We reviewed the literature addressing the use and complications associ ated with low-viscosity distention fluids in urologic and hysteroscopi c procedures. The possible causes of fluid complications included elev ated intrauterine pressure, myometrial invasion, prolonged operating t ime and operative trauma to the cervix or uterine body. Physiologic el ectrolyte solutions create only fluid overload, and treatment requires cardiovascular support and diuresis. Nonelectrolytic solutions result in acute dilutional hyponatremia, which has been referred to as the t ransurethral resection of the prostate syndrome. Treatment requires di uresis and a rapid, controlled return of the serum sodium level to 120 -130 mmol. These complications can be minimized with proper use of equ ipment and careful monitoring of fluid volumes. To recognize and treat them, the surgeon must be knowledgeable about the fluid being used an d the difficulties it may cause.