Complications - Hysteroscopy, fractional curettage

  1. Intraoperative Complications

    • Uterine perforation: Immediate cessation of the procedure. Ultrasound examination to confirm the perforation. In mild cases, conservative monitoring may be sufficient; in cases of extensive injury or suspicion of injury to adjacent organs (e.g., bowel, bladder), immediate laparoscopy or laparotomy is necessary.
    • Cervical tear (cervical laceration): A tear of the cervix, usually caused by the insertion of instruments with inadequate dilation. Immediate hemostasis by suturing the cervical laceration. In severe tears, electrosurgical coagulation may be necessary. In cases of heavily bleeding tears, tamponade may be required.
    • Severe bleeding: Local hemostasis by applying hemostatic agents (e.g., adrenaline solution) or electrocoagulation. In cases of uncontrollable bleeding, tamponade may be applied, or in severe cases, an emergency hysterectomy may be necessary.
    • Fluid overload (TUR syndrome): Occurs due to absorption of irrigation fluid, especially when using electrolyte-free solutions. Immediate cessation of fluid supply, monitoring of vital signs and electrolytes. Treatment of electrolyte disturbances and fluid overload (e.g., hyponatremia) with appropriate medications and diuretics.
    • Instrument breakage: Immediate removal of the broken instrument part under visual control. If foreign bodies remain in the uterus, further hysteroscopy or laparoscopy may be necessary.
Postoperative complications

Postoperative infections, such as endometritis or pelvic inflammatory disease (PID): Early administ

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