A possible problem is uterine perforation when either the<unk>  itself or one of its operative instruments breaches the wall of the uterus. This can lead to bleeding and damage to other organs. If other organs such as bowel are injured during a perforation, the resulting peritonitis can be fatal. Furthermore, cervical laceration, intrauterine infection (especially in prolonged procedures), electrical and laser injuries, and complications caused by the distention media can be encountered. The use of insufflation (also called distending) media can lead to serious and even fatal complications due to embolism or fluid overload with electrolyte imbalances. Particularly the electrolyte-free insufflation media increase the risk of fluid overload with electrolyte imbalances, particularly hyponatremia, heart failure as well as pulmonary and cerebral edema. The main factors contributing to fluid overload in<unk>  are: * Hydrostatic pressure of the insufflation media * Amount of exposed blood vessels, such as being increased in endometrial ablation and myomectomy. * Duration of the<unk>  procedure. Women in fertile age are at increased risk of resultant hyponatremic encephalopathy, likely because of increased level of estrogens. The overall complication rate for diagnostic and operative<unk>  was 2% with serious complications occurring in less than 1% of cases using older methods. Morcellation has fewer complications than electrocautery, less than 0.1%. Severe Pain The English Member of Parliament, Lyn Brown (West Ham, Labour), has spoken twice in the House of Commons on behalf of constituents who have been coerced into completing unbearably painful outpatient<unk> es without anaesthesia. Lyn Brown cites numerous instances of women throughout England being held down by nurses in order to complete an ambulatory<unk>  and thus avoid the expense of safely monitored sedation or general anaesthetic. A petition to grant NHS patients full information about the risks of severe outpatient<unk>  pain, and the upfront choice of local anaesthetic, sedation, epidural or general anaesthetic was launched in summer 2018. 'End barbaric NHS<unk> es with inadequate pain-relief'. It asks the Secretary of State for Health to ensure that: 1. All NHS<unk> sts have advanced training in pain medicine. 2. All<unk>  patients receive full written information before the procedure, listing the risks and benefits and explaining that local anaesthetic may be painful and ineffective against the severe pain of cervical dilation, womb distension and biopsy. 3. All<unk>  services are adequately funded so that BEFORE their procedures patients may choose no anaesthesia/ local anaesthesia/ safely monitored conscious sedation/ epidural/ general anaesthetic. 4. The Best Practice Tariff financial incentive, which rewards NHS Trusts who perform a high percentage of<unk> es in outpatients without a trained anaesthetist, is abolished.
Hysteroscopy
Hysterosalpingography
Hysterotomy
LGBT reproduction
Hormonal IUDs
Ovarian culture
Fertility testing
Postcoital test