Complications of fluid overload during hysteroscopic surgery

Abstract

Hysteroscopy is a tool utilized in many diagnostic and therapeutic procedures to remain minimally invasive and reduce complication rates when compared to operative procedures [1]. The incidence of all complications is less than 5%. Fluid overload is one potential complication, occurring in 0.2%–6.0% of cases [1,2]. Fluid distension to optimize visualization relies upon electrolyte-free, hypotonic solutions when surgical equipment includes monopolar cutting tools. Bipolar electrical systems, which enable the use of isotonic distension fluids, may still lead to complications from fluid overload [3]. Reports on this complication in gynecologic surgery is scarce in the literature. However, this does not negate the necessity for attention to this possible adverse event especially considering the ubiquity of hysteroscopy [4]. We describe a patient who underwent a hysteroscopy procedure with hemodynamic and pulmonary complications secondary to fluid overload.