Avaliação da dor em histeroscopia ambulatorial: comparação entre duas técnicas

Diniz, Daniela Barreto Fraguglia Quental; Depes, Daniella de Batista; Pereira, Ana Maria Gomes; David, Sandra; Lippi, Umberto Gazi; Baracat, Fausto Farah; Lopes, Reginaldo Guedes Coelho

doi:10.1590/s0100-72032010000100005

Cited by 14 publications

(4 citation statements)

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“…Justamente por permitir a visão direta de anormalidades na cavidade uterina, a histeroscopia é recomendada em situações cujo diagnóstico é feito de forma visual, como é o caso do nicho uterino 14,15 . Esse exame apresenta uma vantagem em relação aos demais já que, além de possibilitar a exclusão de outras condições patológicas uterinas, pode oferecer abordagem terapêutica quando necessária 1,3,16 .…”

Section: Introductionunclassified

Avaliação da prevalência de istmocele em pacientes com cesariana prévia submetidas ao exame de histeroscopia ambulatorial

Santos,

Tolentino,

Leite

et al. 2023

Braz. J. Develop.

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Introdução: A istmocele, também chamada nicho ou divertículo uterino, é caracterizada pelo fechamento miometrial defeituoso após histerotomia prévia, levando à formação de área hipoecoica na parede anterior do istmo uterino, na cicatriz de cesariana. Sua fisiopatologia não é totalmente elucidada, mas existem questões relacionadas à localização da incisão cirúrgica, formação de aderências precoces e predisposição individual. Por estar associada a sintomas como sangramento uterino anormal (SUA), dor pélvica, infertilidade e complicações obstétricas, o diagnóstico e abordagem da istmocele são importantes para a melhora da qualidade de vida das pacientes por ela acometidas. Objetivo: Estratificar e quantificar os achados sugestivos de istmocele em pacientes com cesariana prévia submetidas à vídeo-histeroscopia ambulatorial em um hospital universitário e compará-los com dados obtidos na literatura. Método: Trata-se de um estudo observacional, analítico e transversal prospectivo que avaliou a presença de istmocele nas pacientes com cesariana prévia submetidas à vídeo-histeroscopia em hospital universitário no período de março de 2022 a dezembro de 2022. Resultados: No estudo, foram avaliadas 240 pacientes, das quais 29 (12,1%) foram diagnosticadas com istmocele. Destas, 27,58% eram assintomáticas e, dentre as sintomáticas, a dor pélvica (65,51%) e o SUA (55,1%) foram os sintomas mais prevalentes. Quanto às cirurgias uterinas anteriores, a despeito da cesariana, 51,73% negaram, enquanto 48,27% já haviam sido submetidas a algum procedimento. Conclusão: Desse modo, foi destacada a relação entre istmocele, sintomatologia ginecológica e complicações obstétricas na amostra avaliada. Quanto à prevalência desse defeito miometrial, o presente artigo apresentou um valor inferior aos encontrados previamente na literatura.

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Section: Introductionunclassified

Avaliação da prevalência de istmocele em pacientes com cesariana prévia submetidas ao exame de histeroscopia ambulatorial

Santos,

Tolentino,

Leite

et al. 2023

Braz. J. Develop.

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“…1,8,10 Thus, the need for anesthesia or analgesia to perform hysteroscopy is still a matter of debate. [16][17][18][19][20] A review published by Cochrane in 2017 concludes that there are still no studies with good evidence proving the effectiveness of some method for pain relief during outpatient hysteroscopy. 21 In addiction, it has been documented that surgical procedures can be associated with increased anxiety, this emotional state can lead to psychologic and physiologic responses, such as reduction of pain threshold.…”

Section: Introductionmentioning

confidence: 99%

Comparative study of pain perception in outpatient hysteroscopy analyzing previous orientation by multimedia

Pace¹,

Pace²,

Morato³

et al. 2019

Hum. Reprod. Arch.

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objectives: To evaluate the impact of previous guidance on the hysteroscopy exam using multimedia resources (film) compared to verbal orientations only, on the pain intensity perceived by the patient during hysteroscopy without anesthesia. Methods: Randomized clinical trial, which included 187 women, who were referred for hysteroscopy. The patients in the experimental group (89) watched an explanatory video just before the exam. The control group (98), however, received only routine verbal guidance about the exam. The degree of pain perceived by all patients was measured 1 and 5 minutes after the procedure using Visual Analog Scale. results: In the experimental group, 1 minute after the examination, 29.2% of the patients reported mild pain, 24.7% moderate pain and 46.1% severe pain. In the control group, 28.6% of the patients reported mild pain, 29.6% moderate pain and 41.8% severe pain. In the analysis 5 minutes after the examination of the experimental group 60.7% of the patients reported mild pain, 28.1% moderate pain and 11.2% severe pain and the control group 62.3% of the patients reported mild pain, 26.5% moderate pain and 11.2% severe pain. Conclusions: The study was not able to demonstrate the relationship of pain perceived by patients with prior multimedia orientation, thus that, more studies are needed.

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“…These factors may prevent the accurate evaluation of pain caused only because of the hysteroscope passing into the uterine cavity. Lower levels of pain have been reported from diagnostic hysteroscopy applied with the vaginoscopy ‘no touch technique' compared to conventional hysteroscopy using a speculum and tenaculum [6,7,8,9]. In the vaginoscopic technique, pain and the effect of the anesthesia used can be more accurately evaluated.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Intrauterine Lidocaine and Rectal Indomethacin on Pain during Office Vaginoscopic Hysteroscopy: Randomized Double-Blind Controlled Study

Şentürk¹,

Güraslan²,

Babaoğlu³

et al. 2015

Gynecol Obstet Invest

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Backgrounds/Aims: The aim of this study was to investigate the effect of rectal and intrauterine anesthesia during vaginoscopic hysteroscopy. Methods: This was a randomized, double-blind, placebo-controlled study. Patients were randomized to rectal indomethacin, intrauterine lidocaine and placebo groups. Patients with conditions that could cause or contribute to pelvic pain were excluded. Pain was evaluated with Visual Analog Scale, when the cervical canal was passed, while within the cavity and at 10 min after procedure. The Analog Pain Scale scores of the 3 groups were compared with the Kruskal-Wallis 1-way analysis of variance test. A value of p < 0.05 was accepted as statistically significant. Results: The study included a total of 206 patients. No difference was seen between the groups in respect of indication, age, gravid and duration of procedure. While the anesthesia was determined as superior to the placebo in reducing pain at all 3 stages (p < 0.05), intrauterine lidocaine was determined to be more effective than rectal indomethacin in reducing pain within the cavity and 10 min after the procedure (p < 0.05). Conclusion: Rectal or intrauterine anesthesia applied with the vaginoscopic technique is useful in hysteroscopy. However, intrauterine anesthesia is more effective in reducing pain.

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Avaliação da dor em histeroscopia ambulatorial: comparação entre duas técnicas

Abstract: vaginohysteroscopy was proved to be a less painful procedure than the technique based on the use of a speculum and CO2, regardless of age, menopause or parity, with more satisfactory results and lower technical difficulty.

Cited by 14 publications

References 0 publications

Avaliação da prevalência de istmocele em pacientes com cesariana prévia submetidas ao exame de histeroscopia ambulatorial

Avaliação da prevalência de istmocele em pacientes com cesariana prévia submetidas ao exame de histeroscopia ambulatorial

Comparative study of pain perception in outpatient hysteroscopy analyzing previous orientation by multimedia

The Effect of Intrauterine Lidocaine and Rectal Indomethacin on Pain during Office Vaginoscopic Hysteroscopy: Randomized Double-Blind Controlled Study

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