Comparison of carbon dioxide with continuous-flow technique for office hysteroscopy

Study Objectives. To determine the effectiveness of lactated D5W-lactated Ringer's solution as the distention medium for office hysteroscopy, and to compare it with carbon dioxide (CO2). Design. Observational, comparative study. Setting. Private practice. Patients. 50 women with fibroids or recurrent bleeding. Interventions. Hysteroscopies with CO2 and with dextrose 5% D5W-lactated Ringer's solution. Measurements and Main Results. Visualization and distention were adequate with both CO2 and fluid in women with no uterine pathology and those with polyps. In 24 women with submucous leiomyomas CO2 distention was relatively inadequate due to bubbling, bleeding, and inability to determine intracavitary penetration. Conclusion. Although CO2 hysteroscopy is a valuable assessment procedure, significant intrauterine pathology may be missed. Instilling lactated D5W-lactated Ringer's solution through small-diameter continuous-flow instruments makes fluid office hysteroscopy practical and desirable for precise diagnosis.