Intrauterine Pressure and Uterine Distention

We attempted to determine the minimum intrauterine pressure required for distention of the uterine cavity during hysteroscopy using saline as a distending medium. Intrauterine perfusion pressure was measured in seven women at the time of hysteroscopy and laparoscopy performed for infertility, pain, or both. Distention of the uterine cavity was achieved when the intrauterine perfusion pressure reached a median of 40 mm Hg (range 25-50 mm Hg). Fluid with the same viscosity as normal saline will distend the uterine cavity at a pressure of approximately 40 mm Hg, lower than we measured previously. Our results suggest that it may be theoretically possible to ablate the endometrial lining with heated fluid without spilling the fluid into the peritoneal cavity.