Effectiveness of Vaginal Misoprostol and Rectal Nonsteroidal Anti-Inflammatory Drug in Vaginoscopic Diagnostic Outpatient Hysteroscopy in Primarily Infertile Women: Double-Blind, Randomized, Controlled Trial

Hassa, Hikmet; Aydın, Yunus; Öge, Tufan; Çiçek, Kıymet

doi:10.1016/j.jmig.2013.07.002

Cited by 45 publications

(30 citation statements)

References 16 publications

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“…Conversely, in the current study, rectal indomethacin was found to be more effective than the placebo. This disparity with the findings of the study by Hassa et al [13] may be due to the low number of nulliparity patients in the current study patient group.…”

Section: Discussioncontrasting

confidence: 99%

“…In the current study, we were not used instrument (speculum and tenaculum) to make more accurate pain-related hysteroscope only and we have shown that intrauterine lidocaine and rectal indomethacin are more effective than placebo with respect to pain control. In a study by Hassa et al [13] in which the vaginoscopic technique was used on 158 patients, it was reported that rectal indomethacin and vaginal misoprostol were no more effective in reducing pain than the placebo. In that study, all the patients were infertile and a 4-mm hysteroscope was used.…”

Section: Discussionmentioning

confidence: 99%

“…The third group was administered with rectal indomethacin suppository (Endol 100 mg supp. Deva, Istanbul, Turkey) 45 min before the procedure [13] and with a 1,000 ml distention medium containing 18 ml serum physiologic per 250 ml. The medications were administered to all the patients by a nurse.…”

Section: Methodsmentioning

confidence: 99%

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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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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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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

View full text Add to dashboard Cite

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“…Other randomized controlled studies which included nulliparous patients or patients of reproductive age in their study population have contradictory results [21][22][23][24]. A randomized controlled trial evaluating the efficacy of vaginal misoprostol and oral misoprostol in minimizing the pain perceived by nulliparous women during office hysteroscopy revealed that vaginal misoprostol significantly reduced the procedure related pain and oral misoprostol was not effective in reducing the procedure related pain [21].…”

Section: Misoprostol Prior To Office Hysteroscopymentioning

confidence: 99%

“…A randomized controlled trial evaluating the efficacy of vaginal misoprostol and oral misoprostol in minimizing the pain perceived by nulliparous women during office hysteroscopy revealed that vaginal misoprostol significantly reduced the procedure related pain and oral misoprostol was not effective in reducing the procedure related pain [21]. On the contrary, Hassa et al [22] found that vaginal misoprostol (200 µg given 6 h before office hysteroscopy) and diclofenac sodium (100 mg administered rectally 1 h before office hysteroscopy) were not effective in minimizing the pain perceived by nulliparous women during office hysteroscopy.…”

Section: Misoprostol Prior To Office Hysteroscopymentioning

confidence: 99%

Misoprostol Prior to Diagnostic Office Hysteroscopy in the Subgroup of Patients with No Risk Factors for Cervical Stenosis: A Randomized Double Blind Placebo-Controlled Trial

Fouda

Elsetohy

Elshaer

et al. 2017

Gynecol Obstet Invest

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Aims: To assess the effectiveness of vaginal misoprostol in minimizing the pain perceived by patients with no risk factors for cervical stenosis (i.e., parous women of reproductive age who have no history of cesarean section or cervical surgery) during diagnostic office hysteroscopy. Methods: A total of 100 patients with no risk factors for cervical stenosis were randomized to the misoprostol group (n = 50) or the placebo group (n = 50). In the misoprostol group, 2 misoprostol tablets (400 µg) were administered vaginally 12 h before office hysteroscopy. In the placebo group, 2 placebo tablets were administered. The patients rated the intensity of pain perceived during the procedure and at 30 min after the procedure with the use of a 100 mm visual analog scale (VAS). The hysteroscopists also scored the difficulty of hysteroscope insertion into the uterine cavity with the use of a 100 mm VAS. Results: There were no significant differences between both groups in the VAS pain scores during or at 30 min after the procedure (28.3 ± 13.58 vs. 30.42 ± 15.13 and 11.1 ± 10.23 vs. 13.32 ± 11.12, respectively). The difficulty of hysteroscope insertion into the uterine cavity was comparable between both groups. Conclusion: Misoprostol administration prior to diagnostic office hysteroscopy appears to have no beneficial role in the subgroup of patients with no risk factors for cervical stenosis.

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Effect of cervical priming with misoprostol on cervical entry in women undergoing vaginoscopic hysteroscopy for evaluation of abnormal uterine bleeding: a randomized controlled trial

Nandhini

Maurya

Keepanasseril

et al. 2018

Arch Gynecol Obstet

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Effectiveness of Vaginal Misoprostol and Rectal Nonsteroidal Anti-Inflammatory Drug in Vaginoscopic Diagnostic Outpatient Hysteroscopy in Primarily Infertile Women: Double-Blind, Randomized, Controlled Trial

Cited by 45 publications

References 16 publications

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

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

Misoprostol Prior to Diagnostic Office Hysteroscopy in the Subgroup of Patients with No Risk Factors for Cervical Stenosis: A Randomized Double Blind Placebo-Controlled Trial

Effect of cervical priming with misoprostol on cervical entry in women undergoing vaginoscopic hysteroscopy for evaluation of abnormal uterine bleeding: a randomized controlled trial

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