Comparison of Two Hysteroscopy Approaches

Last updated: November 27, 2006
Sponsor: Wolfson Medical Center
Overall Status: Completed

Phase

3

Condition

Menstrual Disorders

Heavy Bleeding / Heavy Periods

Dysfunctional Uterine Bleeding

Treatment

N/A

Clinical Study ID

NCT00319410
EWMCgyn-1
  • Female

Study Summary

This randomized clinical trial compares two methods of diagnostic hysteroscopy: vaginoscopic hysteroscopy vs. traditional method. Pain intensity was estimated using a visual analogue scale (VAS), and patient satisfaction was evaluated. These endpoints were compared by treatment assignment. Vaginoscopic hysteroscopy was associated with significantly lower VAS scores, indicating reduced experience of pain in this treatment group; however, this was not associated with improved patient satisfaction.

Eligibility Criteria

Inclusion

Inclusion Criteria:adult female, referred for outpatient diagnostic hysteroscopy,subscriber to Maccabe health maintenance organization -

Exclusion

Exclusion Criteria:heavy vaginal bleeding; severe cervical stenosis; patients refusing theexamination on an outpatient basis.

Study Design

Total Participants: 130
Study Start date:
July 01, 2005
Estimated Completion Date:
December 31, 2005

Study Description

OBJECTIVE: To compare the vaginoscopic approach of diagnostic hysteroscopy without anesthesia with the traditional diagnostic hysteroscopy after intracervical injection of Mepivacaine Hydrochloride 3%.

METHODS: A total of 130 women undergoing diagnostic hysteroscopy were included in the study and were randomized, using a computer-generated randomization list, into two groups with a ratio of 2:1. Eighty three women underwent vaginoscopy without speculum, tenaculum or anesthesia. Forty seven women received intracervical anesthesia with 10 ml of 3% mepivacaine hydrochloride solution injected at two sites (3:00 and 9:00 positions) and underwent traditional hysteroscopy using a speculum and tenaculum. Hysteroscopy was performed using a rigid 3.7 mm hysteroscope in a medium of 0.9% saline, and the image was transmitted to a screen visible to the patient. A Visual Scale Analogue (VAS) consisting of a 10 cm line was used to assess the intensity of pain experienced during and after the procedure. Overall patient satisfaction was assessed during, immediately after, 15 minutes later, and three days post hysteroscopy.

RESULTS: The mean pain score was significantly lower in the vaginoscopy group (3.8±2.7 vs 5.34±3.23, p=0.01). Patient satisfaction rate was similar in both groups.

CONCLUSION: Patients reported significantly less pain with the vaginoscopic approach to diagnostic hysteroscopy even without anesthesia compared to patients undergoing the traditional procedure with anesthesia. This new approach should therefore be considered as a replacement for the traditional hysteroscopic technique.

Connect with a study center

  • Maccabe Health Maintenance Organization

    Tel Aviv,
    Israel

    Site Not Available

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