title: Safety and efficacy of manual syringe infusion of distending media for hysteroscopic procedures: a case-control study.
abstract: OBJECTIVE
  Adverse events associated with large volumes of distending media in hysteroscopic procedures can be life-threatening. The aim of this study was to evaluate the safety and efficacy of manual syringe infusion (MI) of distending media for hysteroscopic procedures.
  
  
  METHODS
  Between January 2011 and December 2013, the medical records of all women who underwent hysteroscopic procedures using MI or the conventional pump-infusion method (PI, the control group) were reviewed. The Wilcoxon rank-sum test, the Chi-square test and the multivariate logistic regression analysis were employed for statistical analysis.
  
  
  RESULTS
  The MI group (n=82) had a significantly lower average volume of infused fluid (1117 ± 712 mL vs. 2216 ± 1502 mL, respectively; p<0.001), less operative time (22.2 ± 9.7 vs. 30.4 ± 9.8 min, respectively; p<0.001) and lower postoperative abdominal pain scores (0.6 ± 0.7 vs. 0.8 ± 0.7, respectively; p=0.04) than the PI group (n=58). Subgroup analysis of women who underwent hysteroscopic myomectomy revealed a significantly lower amount of infused fluid for the MI group than for the PI group (1737 ± 905 mL vs. 3441 ± 1952 mL, respectively; p=0.001). Infused fluid amount (coefficient=0.08, p<0.001) was the only significant independent factor affecting fluid deficit, with a constant of 76.1.
  
  
  CONCLUSIONS
  The MI method appears to be a safe and feasible method for delivering distending media during hysteroscopic procedures.
authors.affiliation: Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao District, New Taipei City 220, Taiwan.
authors.forename: Wan-Hua
authors.initials: WH
authors.lastname: Ting
authors.affiliation: Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei City, Taiwan.
authors.forename: Ho-Hsiung
authors.initials: HH
authors.lastname: Lin
authors.affiliation: Division of Urogynecology and Pelvic Floor Reconstruction, Department of Obstetrics and Gynecology, Chi Mei Foundation Hospital, Tainan, Taiwan; Center of General Education, Chia Nan University of Pharmacy and Science, Tainan, Taiwan.
authors.forename: Ming-Ping
authors.initials: MP
authors.lastname: Wu
authors.affiliation: Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao District, New Taipei City 220, Taiwan.
authors.forename: Fung-Chao
authors.initials: FC
authors.lastname: Tu
authors.affiliation: Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao District, New Taipei City 220, Taiwan.
authors.forename: Fu-Shiang
authors.initials: FS
authors.lastname: Peng
authors.affiliation: Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao District, New Taipei City 220, Taiwan. Electronic address: smhsiao2@gmail.com.
authors.forename: Sheng-Mou
authors.initials: SM
authors.lastname: Hsiao
mesh_terms: D000282:Administration, Intravaginal; D000328:Adult; D000698:Analgesia / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D016022:Case-Control Studies; D058450:Endotamponade / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D016558:Hemostasis, Endoscopic / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007038:Hypotonic Solutions / Q000008:administration & dosage* / Q000009:adverse effects; D015907:Hysteroscopy / Q000009:adverse effects*; D007263:Infusions, Parenteral; D008875:Middle Aged; D061646:Operative Time; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control; D012189:Retrospective Studies; D013594:Syringes; D013624:Taiwan; D063186:Uterine Myomectomy / Q000009:adverse effects*; D014867:Water / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D007038:Hypotonic Solutions; D014867:Water
keywords: Complications; Fluid overload; Hysteroscopy