Bioelectrical impedance monitoring in the prevention of intravasation syndrome during operative hysteroscopy

Objective: Our purpose was to evaluate the efficacy of the Soft Tissue Analyzer (STA, Akern Srl, Firenze, Italy), an instrument for the continuous and noninvasive monitoring of fluid volumes based on the measurement of bioelectrical impedance, used during operative hysteroscopy, in order to prevent intravasation syndrome. Methods: Among a total of 233 consecutive patients experiencing abnormal uterine bleeding (spotting, menorrhagia or menometrorrhagia), 141 underwent hysteroscopic polipectomy and 92 underwent hysteroscopic myomectomy. Bioelectrical data were taken in the preoperative and intraoperative periods. Biochemical data (natriemia and plasma osmolality) were also measured before and after the operation to assess the efficacy of this tool in monitoring these modifications and possible onset of intravasation syndrome. Results: Bioelectrical impedance showed no significant increase in extracellular water as expression of fluid overload by distension media, and this was confirmed by the normality of biochemical data. No case of intravasation syndrome was diagnosed. Conclusions: This method may be considered a useful and safe instrument for fluid-balance monitoring to prevent intraoperative and postoperative conditions of fluid overload during operative hysteroscopy.