Complications of diagnostic and operative hysteroscopy

Objective. To improve methods to prevent hysteroscopic complications (HC) in different types of intrauterine pathology (IP), by scientifically substantiating the rational tactics of hysteroscopic interventions having regard to the acceptability, efficiency, and safety of different technological variants. Subject and methods. A longitudinal observational retrospective case-control study was conducted at the S.P. Botkin City Clinical Hospital. The course of interventions and the development of HC were analyzed examining the case histories of 3570 women aged 19 to 85 years with IP, including 3290 (92.2%) inpatients and 280 (7.8%) outpatients who underwent hysteroscopy in the prehospital stage in January 2010 to January 2012. The indications for hysteroscopy were suspected IP evidenced by small pelvic ultrasound screening; complaints about abnormal uterine bleeding; external uterine orifice polyps visualized during gynecological examination with a mirror, colposcopy, and ultrasound scanning. Thefindings were processed using a package of Statistica programs for Windows 6.0 Stat-Soft. Results. Complications were detected in 16 (0.45%) women of the total number of the examinees with IP who underwent diagnostic or operative hysteroscopy. The most common HC was uterine perforation in 5 (0.14%) women. In the early postoperative period, a complication, such as hematometra, was diagnosed in 3 (0.08%) patients. Two (0.06%) of the 3570 patients had more than one complication. There were a total of 3587 operations; 17 (0.48%) patients had > 1 operation. Conclusion. The likelihood of complications significantly decreased in women over 50 years of age as compared to those aged < 35 years. The timely recognition of HC is primarily essential to implement therapeutic measures and to reduce their negative sequels on women’s health.

hysteroscopic complications, intrauterine pathology