Hysteroscopy in endometrial cancer: new methods to evaluate transtubal leakage of saline distension medium

Eugenio Solima, Valentina Brusati, Antonino Ditto, Shigeki Kusamura, Fabio Martinelli, Francesco Hanozet, Maria L. Carcangiu, Marco Maccauro, Francesco Raspagliesi

Research output: Contribution to journalArticlepeer-review


Objective: This study was undertaken to evaluate transtubal fluid leakage after low pressure office saline solution hysteroscopy. Study Design: Forty stage I/II endometrial cancer patients were submitted to office hysteroscopy at the National Cancer Institute of Milan. Uterine cavity was distended by a 1000-mL saline solution bag, placed 50 cm above the patient's plane. After visualization of uterine cavity, a radiotracer (technetirum Tc 99m) and patent blue dye were injected subendometrially. During the staging surgery peritoneal free fluid was analyzed to detect patent blue dye, technetium Tc 99m or free cancer cell by cytologic examination. Results: Technetium Tc 99m and patent blue dye were detected on the peritoneal surface and in the peritoneal fluid in 2 patients. In 1 of these peritoneal cytology was negative for cancer cells. Peritoneal cytology was positive in 2 cases. Conclusion: The risk of transtubal fluid leakage during hysteroscopy is absent when performed with intrauterine pressure less than 40 mm Hg. Transtubal fluid leakage is not a synonym of cancer cell dissemination.

Original languageEnglish
JournalAmerican Journal of Obstetrics and Gynecology
Issue number2
Publication statusPublished - Feb 2008


  • endometrial cancer
  • hysteroscopy
  • transtubal leakage

ASJC Scopus subject areas

  • Medicine(all)
  • Obstetrics and Gynaecology


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