[Metabolic risks in surgical hysteroscopy].
Operative hysteroscopy is often carried out using glycine as an irrigant. This solution has interesting properties but also metabolic effects that are very well known by urologists. This study is concerned with the biological changes that have occurred after one hundred surgical hysteroscopies of which twenty nine were carried out using glycine. In hysteroscopy the significant variations are concerned with blood levels of protein, the haematocrit, changes in sodium levels and glycaemia. 44.9% of patients had changes greater than 5% as compared with the pre-operative levels. These changes concerned the haematocrit readings and in 57.1% the changes in protein in the blood and in sodium in 12%. The haematocrit changes, the protein changes and to a lesser degree the sodium changes could be correlated with one another but not with changes in glycine levels in the blood. Whatever the pathology inside the uterus, glycine went through in equal quantities. It was particularly significant when there was perforation of the uterus. It is linked to the glycine balance and to the length of time the operation had taken. When a mean quantity of fluid of 2.6 litres was used to irrigate, levels after the operation as compared with before the operation had multiplied 4.5 times. This corresponds to the dosage of glycine used. In five patients out of twenty nine post-operative quantities were 10 times those before operation. The consequences of these changes in glycine levels are variable and seem to be more significant in women who have never been pregnant or who are very heavy. Using vasoconstrictor agents does not alter these metabolic changes.
Boubli
L
L
Service de Gynécologie-Obstétrique, Hôpital de la Conception, Marseille.
Blanc
B
B
Bautrand
E
E
Achilli Cornesse
M E
ME
Houvenaeghel
M
M
Manelli
J C
JC
Aquaron
R
R
D000328:Adult; D001798:Blood Proteins / Q000032:analysis; D005260:Female; D005998:Glycine / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D006400:Hematocrit; D006801:Humans; D015907:Hysteroscopy / Q000379:methods*; D008875:Middle Aged; D012964:Sodium / Q000097:blood; D007507:Therapeutic Irrigation; D014591:Uterine Diseases / Q000097:blood / Q000378:metabolism / Q000601:surgery*
D001798:Blood Proteins; D012964:Sodium; D005998:Glycine
Le risque métabolique de la chirurgie hystéroscopique.