BIOLOGICAL MODIFICATIONS DURING OPERATIVE HYSTEROSCOPY UNDER GLYCINE IRRIGATION

This study was carried out to assess the relations between plasma glyc ine concentrations and the biochemical changes occurring during intra- uterine resections (IUR) under glycine irrigation. Sixty patients with benign uterine conditions were included. They were all ranked ASA 1 o r 2. The biological parameters were assessed before surgery (T0), at t he end of surgery (T1) and 60 min afterwards (T2). They included the b lood count and blood concentrations of sodium, potassium, chloride, pr oteins, bicarbonates, glucose, urea nitrogen, creatinine and glycine. Plasma osmolarity was calculated. The irrigation of the uterine cavity resulted in an increase of glycine concentrations (28 % of cases), an d a decrease of sodium (22 % of cases), proteins and haematocrit (32 % of cases). Mean osmolarity remained unchanged. Blood glycine concentr ations were directly correlated with the volume of irrigating solution , as well as with the duration of surgery. Protidaemia was inversely r elated to the blood glycine concentration. Multiparous patients had lo wer glycine concentrations than nulliparous patients. This was probabl y due to the uterine cavity being less compliant in the latter. On the other hand, there was no correlation with the uterine pathological co ndition. In this series, five cases of uterine perforation occurred wi th very large biological variations, especially a decrease in haematoc rit and osmolarity. In these cases a clinical and biological water int oxication syndrome may occur as a result of large volumes of irrigatin g fluid passing into the peritoneal cavity.