Postoperative infection and surgical hysteroscopy

Area of Science:

• Gynecologic Surgery
• Infectious Disease Epidemiology
• Patient Safety

Background:

• Surgical hysteroscopy is a common gynecologic procedure.
• Understanding postoperative infection risks is crucial for patient care.
• Previous data on infection rates following hysteroscopy is varied.

Purpose of the Study:

• To assess the incidence and types of infectious complications after operative hysteroscopy.
• To identify specific hysteroscopic procedures associated with a higher risk of infection.
• To evaluate the overall safety profile regarding infectious risks in surgical hysteroscopy.

Main Methods:

• Prospective observational study conducted at a university hospital.
• Included 1,952 patients undergoing 2,116 operative hysteroscopies over 10 years.
• Procedures included fibroma resection, polyp resection, endometrectomy, uterine septum section, and lysis of synechiae.
• Postoperative infectious complications were the primary outcome measure.

Main Results:

• A total of 30 infections (1.42%) were observed.
• Infections comprised 18 cases of endometritis (0.85%) and 12 urinary tract infections.
• No severe infectious complications were reported.
• Early-onset endometritis risk was elevated after lysis of synechiae compared to other procedures, but similar across endometrectomy, septum section, fibroma, and polyp resections.

Conclusions:

• Surgical hysteroscopy is associated with a low risk of infection.
• Major infectious complications are rare following these procedures.
• Lysis of synechiae presents a higher risk for early-onset endometritis than other hysteroscopic interventions.