HYSTERECTOMY: QUESTIONS OFTEN ASKED
Fluid is sometimes used in the pelvis before a hysteroscopy to separate the abdominal organs. Could you explain why fluid is used instead of gas and the reasons why one or the other may be used? Do they have any adverse effects?
The procedure of hysteroscopy can be used for diagnosis or treatment, but in either case the uterus must be filled with something so that there is space for the hysteroscope to move about. The materials most commonly used to achieve this are carbon dioxide gas, or fluids such as glycine, dextrose, sorbitol/mannitol, saline and dextran.
Carbon dioxide has been found to be particularly useful for diagnostic hysteroscopy, but it has limited usefulness during surgery because blood causes the formation of bubbles that obscure the view. Consequently carbon dioxide gas tends to be reserved for diagnosing the cause of a problem, while fluid is the norm when hysteroscopic surgery is performed.
Occasionally the fluid or the gas is absorbed into the bloodstream, causing significant problems including an electrical imbalance of the body fluids, fluid overload, or swelling in the lungs or brain. There are several effective methods to prevent complications associated with the absorption of gas or fluid, the most important of which is for the medical team to keep a meticulous record of the amount of material instilled in the uterus and recovered from it.
Who should I see about heavy and prolonged bleeding around the time of menopause?
It would be a good idea to see a gynaecologist as heavy and prolonged bleeding near the time of menopause may be due to cancer. This possibility must be excluded before you embark on treatments such as drug therapy, endometrial resection or hysterectomy.
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