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Carbon dioxide versus normal saline as a uterine distension medium for diagnostic vaginoscopic hysteroscopy in
Massimiliano Pellicano1, Maurizio Guida, Fulvio Zullo
1Department of Obstetrics and Gynecology, University of Naples Federico II., Italy. pellican@unina.it
Objective:
To evaluate the satisfaction rate, efficacy, and complication rate of carbon dioxide (CO(2)) versus normal saline as a uterine distension medium for outpatient diagnostic vaginoscopic hysteroscopy in infertile patients.
Design:
Prospective, randomized multicenter study.
Setting:
Hysteroscopy units in two university hospitals and in a private center.
Patient(S):
One hundred eighty-nine infertile women undergoing outpatient hysteroscopy.
Intervention(S):
Outpatient hysteroscopy was performed with CO(2) (group A) or normal saline (group B) and with endometrial biopsy when indicated.
Main Outcome Measure(S):
Quality of the visualization of the uterine cavity, procedure time, complications, patient discomfort, and satisfaction rate.
Result(S):
Significantly lower abdominal and shoulder tip pain and a lower incidence of vasovagal reactions were observed in group B in comparison with group A. A higher satisfaction rate and a lower operative time were obtained in the normal saline group in comparison with the CO(2) group. Moreover, group A required significantly more analgesics after the procedure than group B.
Conclusion(S):
Uterine distension with normal saline seems to have less adverse effects and is better tolerated by patients. Moreover, it allows operative procedures to be performed with the new bipolar instruments.
