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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

      I appreciate the comments of Laberge et al. Bradley, and Favilli et al. on my editorial “Hysteroscopic Fluid Overload: Prevention, Prevention, Prevention.”
      • Tulandi T.
      Hysteroscopic fluid overload: prevention, prevention, prevention.
      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,
      AAGL. Practice report: practice guidelines for the management of hysteroscopic distending media. (Replaces hysteroscopic fluid monitoring guidelines. J Am Assoc Gynecol Laparosc 2000;7:167–8.).
      the guidelines of the International Society for Gynecologic Endoscopy on hysteroscopic myomectomy,
      • Loddo A.
      • Djokovic D.
      • Drizi A.
      • et al.
      Hysteroscopic myomectomy: The guidelines of the International Society for Gynecologic Endoscopy (ISGE).
      the American College of Obstetricians and Gynecologists committee opinion on hysteroscopy,
      ACOG Committee Opinion
      The use of hysteroscopy for the diagnosis and treatment of intrauterine pathology.
      the combined guidelines of the British Society for Gynaecological Endoscopy and European Society for Gynaecological Endoscopy,
      • Umranikar S.
      • Clark T.J.
      • Saridogan E.
      • et al.
      BSGE/ESGE guideline on management of fluid distension media in operative hysteroscopy.
      and the 2015 Society of Obstetricians and Gynaecologists of Canada guideline on endometrial ablation.
      • Laberge P.
      • Leyland N.
      • Murji A.
      • et al.
      Endometrial ablation in the management of abnormal uterine bleeding.
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      References

        • Tulandi T.
        Hysteroscopic fluid overload: prevention, prevention, prevention.
        J Obstet Gynaecol Can. 2022; 44: 5-6
      1. AAGL. Practice report: practice guidelines for the management of hysteroscopic distending media. (Replaces hysteroscopic fluid monitoring guidelines. J Am Assoc Gynecol Laparosc 2000;7:167–8.).
        J Minim Invasive Gynecol. 2013; 20: 137-148
        • Loddo A.
        • Djokovic D.
        • Drizi A.
        • et al.
        Hysteroscopic myomectomy: The guidelines of the International Society for Gynecologic Endoscopy (ISGE).
        Eur J Obstet Gynecol Reprod Biol. 2022; 268: 121-128
        • ACOG Committee Opinion
        The use of hysteroscopy for the diagnosis and treatment of intrauterine pathology.
        Obstet Gynecol. 2020; 135: e138-e148
        • Umranikar S.
        • Clark T.J.
        • Saridogan E.
        • et al.
        BSGE/ESGE guideline on management of fluid distension media in operative hysteroscopy.
        Gynecol Surg. 2016; 13: 289-303
        • Laberge P.
        • Leyland N.
        • Murji A.
        • et al.
        Endometrial ablation in the management of abnormal uterine bleeding.
        J Obstet Gynaecol Can. 2015; 37: 362-379
        • Istre O.
        • Skajaa K.
        • Schjoensby A.P.
        • et al.
        Changes in serum electrolytes after transcervical resection of endometrium and submucous fibroids with use of glycine 1.5% for uterine irrigation.
        Obstet Gynecol. 1992; 80: 218-222

      Linked Article

      • Letter: Hysteroscopic Fluid Management
        Journal of Obstetrics and Gynaecology Canada Vol. 44Issue 5
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          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.1 However, Dr.
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