A New Approach to Office Hysteroscopy Compared With Traditional Hysteroscopy

Sagiv, Ron; Sadan, Oscar; Boaz, Mona; Dishi, Michal; Schechter, Edwardo; Golan, Abraham

doi:10.1097/01.aog.0000227750.93984.06

Cited by 79 publications

(51 citation statements)

References 23 publications

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“…2,73 One trial randomized 126 women to vaginoscopy without anesthesia and the traditional approach with speculum, tenaculum, and 10 mL 3% mepivacaine intracervical block. 74 The hysteroscopy was performed with normal saline and a rigid 3.7-mm hysteroscope. The women in the vaginoscopy group had mean pain scores of 3.8 compared with 5.3 in the traditional group on a 0-to 10-point scale.…”

Section: Hysteroscopymentioning

confidence: 99%

Pain Management for Gynecologic Procedures in the Office

Ireland¹,

Allen²

2016

Obstetrical &Amp; Gynecological Survey

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Section: Hysteroscopymentioning

confidence: 99%

Pain Management for Gynecologic Procedures in the Office

Ireland¹,

Allen²

2016

Obstetrical &Amp; Gynecological Survey

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“…23 Of the 18 papers reporting data for pain relief, we excluded three from meta-analysis; two because data were reported as the median value 24 or the mean but without standard deviation or standard error, 25 precluding calculation of the standardised mean difference, and another because of differences in intervention between the groups in addition to the use of local anaesthetic. 26 Most of the papers used continuous visual analogue scales (VAS) to assess pain; other studies used ordinal numerical or descriptive scales. Most results were reported as mean or median pain scores.…”

Section: Study Selection Details and Qualitymentioning

confidence: 99%

“…In fact one study found that a vaginoscopic approach to hysteroscopy was significantly less painful than having the procedure done traditionally with a vaginal speculum and a local anaesthetic block. 26 Outpatient hysteroscopy is a multi-faceted procedure, and there are many factors that contribute towards pain. These can be categorised into factors related to the patient (such as menopausal status, reason for hysteroscopy) and procedural factors (such as the type of distension media, use of a speculum, use of a rigid or flexible hysteroscope).…”

Section: Researchmentioning

confidence: 99%

Local anaesthesia for pain control during outpatient hysteroscopy: systematic review and meta-analysis

Cooper

Khan

Clark

2010

BMJ

125

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Natalie A M Cooper, clinical research fellow Khalid S Khan, professor of obstetrics and gynaecology and clinical epidemiology, honorary consultant obstetrician and gynaecologist T Justin Clark, consultant obstetrician and gynaecologist and honorary senior lecturer ABSTRACT Objective To compare the effects of different types of local anaesthetic for pain control during outpatient hysteroscopy. Design Systematic review and meta-analysis of randomised controlled trials. Setting Outpatient hysteroscopy clinics. Participants Women undergoing diagnostic or operative hysteroscopy as outpatients-that is, without general anaesthesia. Study selection criteria Medline, Embase, CINAHL, the Cochrane library, and reference lists of relevant studies. Two reviewers independently selected trials. Data were abstracted on quality, characteristics, and results. Results There were 20 trials (2851 participants). Data from 15 of these were meta-analysed in subgroups defined by type of intervention and study quality. Intracervical (standardised mean difference −0.36, 95% confidence interval −0.61 to −0.10, I 2 =0%) and paracervical (−1.28, −2.22 to −0.35, I 2 =97%) injections of local anaesthetic significantly reduced the pain in women undergoing hysteroscopy as outpatients, whereas transcervical (−0.11, −0.31 to 0.10, I 2 =27%) and topical application (−0.32, −0.97 to 0.33, I 2 = 90%) did not. Meta-regression showed that paracervical injection was superior to the other anaesthetic methods (P=0.04), a finding that was supported by the high quality subgroup of studies. Use of local anaesthetic did not have a significant effect on the incidence of vasovagal episodes (P=0.09). Conclusions Paracervical local anaesthetic injection is the best method of pain control for women undergoing hysteroscopy as outpatients.

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“…Following both procedures, patients usually consider the EMB to be more painful than hysteroscopy (author's personal experience). This is especially the case when hysteroscopy is performed by the Bettochi technique (11,12).…”

Section: Hysteroscopic Guided Embmentioning

confidence: 99%