TY - JOUR AU - March, Charles M. AB -
To the Editors:
We read Yazicioğlu's letter with interest and appreciation and are happy to address his questions and concerns. The 13 cases were not excluded solely for bleeding, a problem amenable to a continuous-flow hysteroscopic system with a liquid medium, but, as stated in the article, exclusions were also for pain, false tracts, and a perforation or a patulous cervix that precluded adequate uterine distention. 1 The technique suggested by Yazicioğlu would solve the bubbling problem with carbon dioxide but could only provide a clear view for patients who are bleeding actively if “rinsing” of the cavity was permitted by overdilation of the cervix or by reflux through the fallopian tubes. The complications of two false tracts and one perforation occurred in women with cervical stenosis as the result of the cervical dilatation, not placement of the hysteroscope, which was passed under direct visualization and permitted the surgeon to diagnose the complication. We could not have passed a flexible plastic catheter into these uteri for either Yazicioğlu's technique of hysteroscopy or for sonohysterography. If a dilator had been used before catheter placement, the same injury would have occurred. We agree that endometrial “texture” is often different in TI - Reply JF - American Journal of Obstetrics and Gynecology DO - 10.1016/S0002-9378(97)70629-X DA - 1997-04-01 UR - https://www.deepdyve.com/lp/wolters-kluwer-health/reply-ade87IXByt SP - 950 EP - 951 VL - 176 IS - 4 DP - DeepDyve ER -