Risk of Uterine Perforation during Hysteroscopic Surgery

To evaluate the rate of uterine perforation during different operative hysteroscopy procedures. Observational study (Canadian Task Force classification II-2). Department of Obstetrics and Gynecology, La Conception Hospital, Marseille, France. One thousand nine hundred fifty-two women. Of 2116 operative hysteroscopies performed, there were 623 endometrectomies, 782 myoma resections, 422 polyp resections, 199 adhesiolyses, and 90 uterine septa sections. Risk of perforation was evaluated according to hysteroscopic procedure. Severity of complications were also noted. In case of perforation, a management protocol was applied to prevent metabolic disorders and pelvic infections. Thirty-four perforations (1.61%) were reported. In 33 cases (97%) it was realized during the procedure and no complications occurred during follow-up. One perforation with hemorrhage was misdiagnosed during the intervention and required laparotomy. Perforation risk was higher during hysteroscopic adhesiolysis than during other procedures [endometrial ablation RR 9.39 (3.46–25.52), p