Operative hysteroscopy for infertility using normal saline solution and a coaxial bipolar electrode: a pilot study

The efficacy and safety of a coaxial bipolar electrode surgical system used to treat surgically remediable infertility conditions was investigated, Af ter gaining initial experience with 50 patients with perimenopausal menorrh agia, 40 infertile patients with submucous myomas (n = 12), uterine septum (n = 1.2), uterine adhesions (n = 11), and uterine hypoplasia (n = 5) were treated. Bipolar electrodes were inserted through a '5' French operating ch annel of a 5.5 mm hysteroscope without cervical dilatation. Three electrode s were used: hall, twizzle and spring, Power settings ranged from 50 W (des iccation mode) to 200 W (vapour cut mode). Normal saline was used as the di stension medium. All the procedures were completed within 30 min using a 1 l bag of normal saline solution. No episodes of cervical laceration, uterin e perforation, haemorrhage, fluid overload or thermal injury occurred. Mild cramping, vaginal bleeding and vaginal discharge were common during the fi rst week. No patients were readmitted. This new surgical approach appears t o be well tolerated, safe, and is an effective alternative to conventional hysteroscopic surgery in the treatment of intrauterine lesions.