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Acceptability and pain of outpatient hysteroscopy
P De Iaco1, A Marabini, M Stefanetti
1Department of Obstetrics and Gynecology, Universitá di Bologna, via Massarenti 13, 40138 Bologna, Italy.
Study Objective:
To investigate the pain and acceptability of diagnostic hysteroscopy performed without local anesthesia.
Design:
Prospective, observational study (Canadian Task Force classification II-2).
Setting:
University-associated department of obstetrics and gynecology.
Patients:
The 1144 consecutive women who underwent diagnostic hysteroscopy.
Interventions:
Diagnostic hysteroscopy and endometrial biopsy as indicated.
Measurements And Main Results:
Patients were asked to rate the pain experienced on a 10-cm visual analog scale and to state if they were willing to repeat the procedure. The mean pain score was 4.7 +/- 2.5; 398 patients (34.8%) experienced severe pain. No risk factors for painful hysteroscopy were found, although abnormality of the cervical canal was associated with high pain scores. Acceptance of the procedure was high, 83.0% (950 women).
Conclusion:
Diagnostic hysteroscopy is a painful procedure even when performed with atraumatic technique by experienced surgeons. Most women, however, stated they were willing to have a second procedure under the same conditions.