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

Pain in diagnostic hysteroscopy: a multivariate analysis after a randomized, controlled trial

“…Our data support the concept previously expressed by Mcllwaine et al (35) and van Dongen et al (2) that neither menopause nor advanced age significantly influence discomfort in hysteroscopy, whereas other studies do not confirm this hypothesis (1,27,28). Moreover, the previously declared protective role of parity (2,27) was confirmed in this analysis.…”

“…Moreover, the previously declared protective role of parity (2,27) was confirmed in this analysis. In our experience, patients with previous cesarean sections did not perceive more severe pain during the hysteroscopy, whereas Cicinelli et al (28) affirmed that cesarean sections, menopause, chronic pelvic pain, and a state of anxiety are predictive individual risk factors for pain in diagnostic hysteroscopy.…”

“…Unlike other studies (1,15,17,27,29), we deemed it advisable to also exclude women who underwent an endometrial biopsy during the hysteroscopy. In 2007 de Carvalho Schettini et al (27) published a nonrandomized, observational study with a multivariate analysis examining the causes of pain in hysteroscopy, but the procedure was performed using two different hysteroscopes, the aid of a tenaculum, and with a biopsy.…”

“…In 2007 de Carvalho Schettini et al (27) published a nonrandomized, observational study with a multivariate analysis examining the causes of pain in hysteroscopy, but the procedure was performed using two different hysteroscopes, the aid of a tenaculum, and with a biopsy. Moreover, women who had previously undergone cervical surgery were also excluded from the study, because they presented a higher risk of cervical synechiae (27). We considered patients in a ''zone of analgesic success'' if the VAS score was %3 (22)(23)(24).…”

“…Many studies have focused on different variables that influence pain (4,8,12,15,19,(26)(27)(28), particularly on distension media. In a recent meta-analysis Craciunas et al (21) reported that most of the included studies were of low methodologic quality owing to unsuitableness of the randomization technique, allocation concealment, blinding, and power calculation.…”