Severe intraoperative hyponatremia in a patient scheduled for elective hysteroscopy: a case report

Hysteroscopy is a minimally invasive procedure that may result in potentially disastrous complications. A hysteroscopy requires the insertion of a hysteroscope into the uterine cavity and the installation of a suitable distention medium for visualization of the endometrium. Potential risks include fluid volume overload, uterine perforation, hemorrhage, infection, and the need for immediate hysterectomy. Solutions most commonly used for distention of the uterine cavity are 1.5% glycine and sorbitol. Hypotonic, electrolyte-free distention media have the potential to be absorbed in volumes large enough to cause hyponatremia and hypervolemia, complications initially described as transurethral resection of the prostate (TURP) syndrome. Hyponatremia and hypervolemia have been associated with hysteroscopic surgical procedures. The following is a case report detailing the perioperative events of a 40-year-old woman in whom severe hyponatremia developed during an elective hysteroscopy.