Diagnostic and interventional microhysteroscopy with use of the coaxial bipolar electrode system.

OBJECTIVE: To assess the efficacy and safety as a diagnostic and interventional outpatient procedure of microhysteroscopy using the coaxial bipolar electrode system (Versascope, Versapoint Electrosurgical System; Gynecare Inc., Menlo Park, CA) with normal saline solution as an irrigation medium.
DESIGN: Analysis of 151 cases of diagnostic and interventional procedures.
SETTING: Urban tertiary care center and teaching hospital. PATIENT(S): One hundred fifty-one women of reproductive age. INTERVENTION(S): Apart from diagnostic procedures, operative procedures were carried out microhysteroscopically with the coaxial bipolar electrode system. RESULT(S): Of the 151 patients who underwent the procedures, 94 received diagnostic microhysteroscopies, and 11 underwent the procedure for synechiotomy, 18 for polypectomy, 3 for submucus myoma resections, 7 for tubal cannulations, 5 for incomplete septal resection, 5 for endometrial ablation, and 8 for complete septal resection out of which 1 was completed with a 27F resectoscope using a knife monopolar electrode. All the patients were discharged the same day as admission. CONCLUSION(S): Use of a microhysteroscope with the coaxial bipolar electrode system is an effective alternative for carrying out diagnostic as well as operative microhysteroscopies. Although the field of vision is limited, with experience nearly all the procedures of hysteroscopy can be carried out as outpatient procedures using normal saline as the irrigation medium, thus avoiding the complications of glycine.