Irrigating fluid absorption from the intact uterus.

Abstract

Absorption of irrigating fluid may occur through severed blood vessels during endometrial resection. We studied whether irrigating fluid can also be absorbed through the undamaged uterus. We studied 25 women, aged 28-46 years (mean 38 years), who underwent elective laparoscopic sterilisation under general anaesthesia. In 15 women blue-stained irrigating fluid containing glycine 1.5% and ethanol 1% was applied to the uterine cavity under increasing pressure. Laparoscopy was employed to see when fluid emerged from the Fallopian tubes. Another 10 women had their Fallopian tubes clamped before the fluid pressure was raised, and systemic absorption was detected by measuring the serum glycine concentration. Passage of fluid through the Fallopian tubes occurred in 14 of the 15 patients at a uteroabdominal pressure gradient of 40 mmHg (n = 4), 80 mmHg (n = 4), 120 mmHg (n = 3), and 160 mmHg (n = 3), respectively. The fluid passage rate ranged between 0.5 and 13 (mean 6.4) ml min-1. Of the women with clamped Fallopian tubes, 8 of 10 showed an increase in the serum glycine level of 60% at a pressure gradient of 160 mmHg, and of 120% at 200 mmHg. Uterotubal and transendometrial passage of small to moderate amounts of irrigating solution occurred frequently at the intrauterine fluid pressures normally used during endometrial resection.