Guest Column | December 7, 2020

Fluid Management Equipment Market Poised For Growth in Europe

By Dr. Kamran Zamanian and Ciara McKillop, iData Research Inc.

The gynecology market in Europe is evolving due to the increasing awareness of the importance of patient safety during hysteroscopic procedures. As the use of hysteroscopes and other less invasive methods increases, more procedures will require the use of fluid management equipment. Despite a significant decline in the number of procedures due to COVID-19, the procedural growth is still expected drive the market for fluid management in Europe.

One of the key benefits of fluid management equipment is that it gives the physician control of the situation by manipulating the valve to obtain satisfactory distention and visualization. Thus, technological advancements continue to shape the competitive landscape in the European market, with multiple companies adapting to suit the changing needs of physicians and to ensure patient safety.

How Is The Fluid Management System Market Pivoting?

Minimally invasive surgery continues to transform the field of gynecologic oncology and has now become the standard of care for many early-stage malignancies. Most physicians prefer to perform the least invasive procedures possible, both for patient comfort and for safety. As a result, the use of hysteroscopes and other less invasive methods are increasing, which, in turn, has led to an increase in demand for fluid management systems.

During a hysteroscope procedure, the uterine cavity can be filled with fluid. While the type of fluid used varies based on the patient’s needs and the physician’s preference, it is very important for the fluid pressure and absorption to be closely monitored for all types of fluid. If the patient absorbs too much fluid, she can suffer respiratory issues, agitation, or vomiting, and she can even lapse into a coma. Since patient safety is a primary concern for physicians, hysteroscopic procedures are now rarely performed without fluid monitoring equipment to prevent these issues. This is driving the market, as an increasing number of physicians are investing in capital equipment.

Finally, there is a transition from the use of gravity bags to pump systems. Pressure-sensitive pumps reduce the flow rate when the preset level is reached, as opposed to gravity bags or simple pump devices that continue to press fluid into the uterine cavity regardless of resistance. While the benefit of using pressure-sensitive pumps is less vital for diagnostic hysteroscopy and simple procedures, maintenance of a standard intrauterine pressure is essential for prolonged operative interventions. This movement toward using pump systems is set to increase the value of the fluid management equipment market significantly as they are significantly more expensive. The rate of transition varies across countries in Europe, with the UK currently being slowest to adapt as the priority of patient safety regarding fluid management is still not well emphasized in the country.

Growth In Minimally Invasive Procedures Drives The Market

There has been significant growth in the sales of both capital equipment and tubing for fluid management during hysteroscopic procedures. By 2026, the value of the fluid management capital equipment market will increase at a compound annual growth rate (CAGR) of 1.9% according to the latest market study by iData Research.1 Due to growth in the number of procedures, physicians will need to replace their fluid management systems more quickly, while more healthcare facilities are expected to purchase new systems.

Because tubing is a disposable product, it is also seeing significant growth in sales due to the increase in the number of hysteroscopic procedures The market fluid management equipment market is mainly dominated by sales in the tubing set segment, despite this segment having much lower average selling prices than the capital equipment segment. The market is expected to decline slightly over the coming years as increased competition leads to a decline in average selling prices.

The average selling prices of capital equipment is expected to remain stable with a slight increase by 2026. While the prices may increase at a much higher rate over time, it becomes largely dependent on the approval of devices like Hologic’s Fluent fluid management system (see next section). As physicians try to avoid surgical procedures, more procedures will be performed with hysteroscopes and will require fluid management systems and tubing.

Major Changes To The Competitive Landscape

Although Karl Storz is currently the market leader with its Hysteromat E.A.S.I. device, its position is likely to be challenged in this increasingly competitive market. Other competitors within the market include Richard Wolf with its Fluid Control 2225 and Olympus’ HysteroFlow Balance II system. Olympus has taken over all commercial activities related to Ethicon’s Versapoint system, which is expected to strengthen its position within the fluid management equipment market as well.

The development of advanced technology such as Hologic’s new Fluent device, which is currently dependent on CE mark approval in Europe, may further propel both capital equipment and tubing unit sales growth. The Fluent device has been rapidly adopted by physicians in the U.S. since its FDA approval in 2018. Approval of the device in Europe would likely revolutionize the market and propel market growth for both capital equipment and tubing. Unlike alternative products in the market, the Fluent system is dedicated to reducing the complexity of workflow by integrating directly with hysteroscopic devices. When the product receives CE mark approval, the fluid management equipment segment will likely experience substantial price increases over the years until the market habituates to technological advancements.

COVID-19’s Impact And The Future Of The Fluid Management Market

The impact of the COVID-19 pandemic on the fluid management equipment market is expected to be significant. It is likely that the severity of the impact will be similar to the impact on the hysteroscope market as the majority of fluid management systems are used in hysteroscopic procedures. The decline in the number of procedures is a result of the delay in diagnosis and treatment of intrauterine pathologies and is expected to have a significant impact on fluid management disposables and capital equipment.

Moving toward minimally invasive surgery and increasing awareness of patient safety will be two of the most important factors in propelling the market in coming years. Most physicians prefer to perform the least invasive procedures possible both for patient comfort and safety. As the use of hysteroscopes and other less invasive methods increases, more procedures will require the use of fluid management equipment, which will drive the market.

About the Authors

CiaraCiara McKillop is a research analyst at iData Research. She has been involved in custom and syndicated market research projects, publishing research on the gynecology, cardiac surgery, and dental implant markets.


KamranKamran Zamanian, Ph.D., is CEO and founding partner of iData Research. He has spent over 20 years working in the market research industry with a dedication to the study of medical devices used in the health of patients all over the globe.

About iData Research

For more than 15 years, iData Research has been a strong advocate for data-driven decision-making within the global medical device, dental, and pharmaceutical industries. By providing custom research and consulting solutions, iData empowers its clients to trust the source of data and make important strategic decisions with confidence.


  1. European Market Report Suite for Gynecological Devices with COVID19 Impact (2020), iData Research Inc.