Letter: Hysteroscopic Fluid Management

Published:February 12, 2022DOI:
      We read with great interest the editorial written by Dr. Tulandi in the January edition of JOGC on the dangers of fluid absorption during hysteroscopic surgery. We fully agree on the importance of carefully monitoring fluid absorption and also agree on tips and tricks to mitigate absorption, which are recommended in his editorial. We add to these suggestions minimizing the use of general anesthesia, which is associated with more fluid absorption than local anesthesia with intravenous sedation.
      • Bergeron M.E.
      • Beaudet C.
      • Bujold E.
      • et al.
      Glycine absorption in operative hysteroscopy: the impact of anesthesia.
      However, Dr. Tulandi mentions that the procedure should be immediately stopped at a maximum deficit of 1000 mL for unipolar hysteroscopic surgery using glycine solution, based on the American Association of Gynecologic Laparoscopists guideline he contributed to more than 20 years ago.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Obstetrics and Gynaecology Canada
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Bergeron M.E.
        • Beaudet C.
        • Bujold E.
        • et al.
        Glycine absorption in operative hysteroscopy: the impact of anesthesia.
        Am J Obstet Gynecol. 2009; 200: 331e1-331e5
        • SOGC Clinical Practice Guideline no. 322
        Endometrial ablation in the management of abnormal uterine bleeding.
        J Obstet Gynaecol Can. 2015; 37: 362-376
        • Istre O.
        • Skajaa K.
        • Schjoencby A.
        • et al.
        Changes in serum electrolytes after transcervical resection of endometrium and submucous fibroids with glycine 1.5% for uterine irrigation.
        Obstet Gynecol. 1992; 80: 218-222

      Linked Article

      • Reply to Letters to the Editor: Hysteroscopic Fluid Management, Keeping Lawyers and Lifeguards Out of the Operating Room during Operative Hysteroscopy, and Pay Attention to False Myths
        Journal of Obstetrics and Gynaecology Canada Vol. 44Issue 5
        • Preview
          I appreciate the comments of Laberge et al. Bradley, and Favilli et al. on my editorial “Hysteroscopic Fluid Overload: Prevention, Prevention, Prevention.”1 It is indeed an important topic that has to be addressed. For the purpose of the editorial, I consulted the following sources: Practice Guidelines for the Management of Hysteroscopic Distending Media from the American Association for Gynecologic Laparoscopists,2 the guidelines of the International Society for Gynecologic Endoscopy on hysteroscopic myomectomy,3 the American College of Obstetricians and Gynecologists committee opinion on hysteroscopy,4 the combined guidelines of the British Society for Gynaecological Endoscopy and European Society for Gynaecological Endoscopy,5 and the 2015 Society of Obstetricians and Gynaecologists of Canada guideline on endometrial ablation.
        • Full-Text
        • PDF