Pain evaluation in outpatients undergoing diagnostic anesthesia-free hysteroscopy in a teaching hospital: A cohort study

Schettini, Juliana; Amorim, Melânia Maria Ramos; Costa, André dos Santos; Neto, Luiz Cavalcante Albuquerque

doi:10.1016/j.jmig.2007.05.009

Cited by 48 publications

(31 citation statements)

References 28 publications

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“…Also, with experience the time needed to complete the procedure is shortened. Some studies noted that the duration of hysteroscopy was significantly longer in patients who experienced severe pain 15,17 , although, this was not agreed upon by other studies that found no direct correlation between duration of the procedure and the severity of pain 7,18,19 . In our study, impact of operator-related pain is nullified by performance of all procedures by the same hysteroscopist and there was no significant difference in duration between both groups.…”

Section: Discussionmentioning

confidence: 88%

“…Many patient characteristics have been evaluated to identify predictive factors for pain experienced during OH including level of anxiety, menopausal state, parity, chronic pelvic pain, history of previous cesarean delivery and body mass index (BMI) [7][8][9][10][11] . However, there is no report in the literature on the impact of tubal blockage on pain experienced during the procedure.…”

Section: Introductionmentioning

confidence: 99%

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Do Patients With Blocked Tubes Experience More Pain During Outpatient Hysteroscopy Than Those With Patent Tubes?! A Prospective Comparative Study

2017

Evidence Based Women's Health Journal

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Objective: To study the impact of tubal blockage on pain experienced during and immediately after diagnostic outpatient hysteroscopy. Study design: A prospective comparative study (Canadian Task Force Classification II-2). Setting: Outpatient hysteroscopy clinic at a University Hospital. Patients and Methods:We included 140 women in the childbearing period attending outpatient hysteroscopy clinic for infertility or recurrent miscarriage. Patients were divided into two equal groups; Group-A included those with unilateral or bilateral tubal block (n=70) and Group-B included those with patent tubes on both sides (n =70). All patients had diagnostic outpatient hysteroscopy without the use of anaesthesia or analgesia. Outcomes measured included pain experienced during and immediately after the procedure assessed using a 100 mm -Visual Analogue Scale (VAS) and the successful completion of the procedure. Results: Patients with blocked tubes experienced statistically significant more pain than those with patent tubes both during and immediately after the procedure using a uterine filling pressure of 80 -100 mmHg. However, all procedures were successfully completed with no failures or complications. Conclusion: Blocked Fallopian tubes contribute to pain during and immediately after outpatient hysteroscopy when a uterine filling pressure of 80-100 mmHg is used. However, this didn't adversely affect the success rate of the procedure. For this group of patients, strategies to improve patients' satisfaction need to be studied with a special attention for; the use of lower uterine filling pressures, shortening the procedure duration and/or the use of preemptive analgesics.

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Section: Discussionmentioning

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Do Patients With Blocked Tubes Experience More Pain During Outpatient Hysteroscopy Than Those With Patent Tubes?! A Prospective Comparative Study

2017

Evidence Based Women's Health Journal

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“…16,17 Schettini D et al have also found that menopause alterations in the female genitalia usually require the need for additional cervical dilation and tenaculum use, which is another factor associated with pain, especially in patients not having experienced previous vaginal delivery. 18 The patients' experience of hysteroscopy is also influenced by their recovery from the procedure. As those from the procedure room group did not need to recover from conscious sedation, they were able to return to work, to return to regular activities and to drive much sooner.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic hysteroscopy in a procedure room setting compared to diagnostic hysteroscopy in the operating room

Oraif

2016

Int J Reprod Contracept Obstet Gynecol

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“…Recent articles showed that the use of saline for distension instead of carbon dioxide gas reduces pain, and that vaginoscopy approach, developed by Bettocchi et al, with no need of speculum or tenaculum, seems to be well tolerated by patients (1,4,6,(17)(18)(19)(20)(21) . cOnclUSiOnS Outpatient diagnostic hysteroscopy with gas can be associated with moderate but tolerable discomfort (mean pain score of 6 in a 0 to 10 pain scale, with 91.4% acceptance to repeat the exam), with satisfying results.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of pain in outpatient diagnostic hysteroscopy with gas

Diniz

Depes

Santos

et al. 2010

Einstein (São Paulo)

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Objective: To evaluate the intensity of pain reported by patients undergoing outpatient diagnostic hysteroscopy. Methods: Exam performed with a 5-mm lens hysteroscope, vaginal speculum, tenaculum and uterine distention with carbon dioxide gas. Before and after the examination, patients were interviewed to define, in a verbal scale from 0 to 10, pain values that they expected to feel and that they experienced after the end, and also if they would repeat it if indicated. Data were analyzed using Statistical Package for the Social Sciences 15.0, statistic significance was defined as p < 0.05 with a study power of 95%. results: Fifty-eight patients were included with mean age of 50.9 years, with 32.8% at postmenopause and 6.9% nulliparous. Among those with previous deliveries, mean parity was 2.21 and at least one vaginal delivery had occurred in 63.8%. Only 24.1% of patients knew how the exam would be done, 62.1% needed an endometrial sample and the result was considered satisfactory in 89.7%. The means of expected and experienced pain were similar (6.0 versus 6.1), and 91.4% of women would repeat the hysteroscopy if necessary. The only factor associated with less pain after the exam was previous vaginal delivery, with a decrease of pain score from 7.1 to 5.5 (p = 0.03). Mean pain was significantly lower in those who agreed to repeat the exam (5.8 versus 9.4; p = 0.003). conclusions: Outpatient diagnostic hysteroscopy with gas can be associated with moderate but tolerable discomfort and satisfactory results.Keywords: Pain measurement; Pain measurement/diagnosis; Hysteroscopy/methods; Ambulatorial care; Outcome and process assessment (Health Care) reSUMO Objetivo: Avaliar a intensidade da dor referida pelas pacientes submetidas à histeroscopia diagnóstica ambulatorial. Métodos: Exame realizado com ótica de 5 mm, espéculo, pinçamento do colo com Pozzi e distensão da cavidade uterina com dióxido de carbono. Antes e depois do exame, as pacientes foram entrevistadas para definir, em uma escala verbal de 0 a 10, valores para espectativa de dor e dor experimentada após seu término, e também se elas o repetiriam se houvesse indicação. Os dados foram analisados no Statistical Package for the Social Sciences 15.0, com significância estatística definida como p < 0,05 e poder do teste de 95%. resultados: Foram incluídas 58 pacientes, com idade média de 50,9 anos, sendo 32,8% na pós-menopausa e 6,9% nulíparas. Dentre as pacientes com partos anteriores, a paridade média foi 2,21 e pelo menos um parto normal ocorreu em 63,8%. Apenas 24,1% das pacientes sabiam como o exame seria feito, 62,1% necessitaram de biópsia endometrial e o resultado foi considerado satisfatório em 89,7% dos casos. As médias de dor esperada e referida pelas pacientes foram semelhantes (6,0 versus 6,1), e 91,4% das mulheres repetiriam a histeroscopia quando necessário. O único fator associado à redução da dor após o exame foi o antecedente de parto normal, com queda de 7,1 para 5,5 (p = 0,03). A média de dor foi significativamente menor nas pacientes...

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Pain evaluation in outpatients undergoing diagnostic anesthesia-free hysteroscopy in a teaching hospital: A cohort study

Cited by 48 publications

References 28 publications

Do Patients With Blocked Tubes Experience More Pain During Outpatient Hysteroscopy Than Those With Patent Tubes?! A Prospective Comparative Study

Do Patients With Blocked Tubes Experience More Pain During Outpatient Hysteroscopy Than Those With Patent Tubes?! A Prospective Comparative Study

Diagnostic hysteroscopy in a procedure room setting compared to diagnostic hysteroscopy in the operating room

Evaluation of pain in outpatient diagnostic hysteroscopy with gas

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