Complications of fluid overloading with different distention media in hysteroscopy--a report of two cases

Complications arising from hysteroscopy are relatively rare events. They occur more frequently with operative hysteroscopy than with diagnostic hysteroscopy. Hysteroscopic procedures, which are alternatives to hysterectomy for surgical treatment of menorrhagia and uterine fibroids, place women to run the risk of intravasation of uterine distention fluid. Excessive intravasation can entail fluid overload, pulmonary edema, congestive heart failure, and electrolyte imbalances. The prerequisite for treatment of hysteroscopic fluid overload is knowing the nature of the intravasation fluid and it should be promptly treated to prevent neurological sequelae. Almost all serious complications of operative hysteroscopy can be avoided if proper precautions are taken and close communication is maintained between the gynecologic surgeon, the anesthesiologist, and nursing staff. Here, we present two cases of fluid overload with acute pulmonary edema and electrolyte imbalance from hysteroscopy with different distention media.