Safety and efficacy of manual syringe infusion of distending media for hysteroscopic procedures: a case–control study

ObjectivesAdverse 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.Study designBetween 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.ResultsThe 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.ConclusionThe MI method appears to be a safe and feasible method for delivering distending media during hysteroscopic procedures.