Original articleA Randomized Trial of Outpatient Hysteroscopy with and without Intrauterine Anesthesia
Section snippets
Materials and Methods
Between August 2006 and June 2007, 82 infertile women undergoing outpatient hysteroscopy were randomized into hysteroscopy using local cervical anesthesia or combined cervical and intrauterine anesthesia. Randomization was done using a computer-generated random table. The hospital research ethics board approved the study. Study participants were counseled, and informed consent was obtained before randomization.
Following our standard practice, all patients were given an anxiolytic (lorazepam 10
Results
Of 82 patients recruited, 4 were excluded from the analysis (2 from each group). Three patients withdrew their consent and another could not tolerate speculum examination. As a result, 36 patients were in the local cervical group and 42 patients in the combined cervical and intrauterine group. In all cases, cervical dilatation was not required and the hysteroscope was introduced only once.
Profiles of the patients in the 2 groups were comparable (Table 1). Patients experienced significantly more
Discussion
Hysteroscopy is an important tool to evaluate the uterine cavity. In our infertile population, most patients had normal uterine cavity. As patients with abnormal sonohysterography results had been excluded before hysteroscopy, our findings are expected. In the past few years, we also performed endometrial biopsy immediately after the completion of hysteroscopy examination. Those with chronic endometritis on histopathology are treated with antibiotics before undergoing treatment with in vitro
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2014, European Journal of Obstetrics and Gynecology and Reproductive BiologyCitation Excerpt :For this reason, numerous studies have evaluated the effectiveness of alternative solutions in an attempt to make the investigation less painful. These include the use of normal saline instead of carbon dioxide (CO2) [5], the use of small-calibre [6] or flexible [7] hysteroscopes, a vaginoscopic approach [8], the administration of prostaglandins to induce cervical dilation [9], and recourse to analgesia [10] or local anaesthesia [11]. Some studies have sought to identify the variables responsible for pain during diagnostic hysteroscopy [12–14], but none of them has studied the correlation between pain and the characteristics of the cervix, particularly the morphology of the cervical canal.
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The authors have no commercial, proprietary, or financial interest in the products or companies described in this article.
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