Risk of vasovagal syndrome during outpatient hysteroscopy

To evaluate influence of hysteroscope type and media used during outpatient hysteroscopy on vasovagal syndrome risk.

Prospective observational study (Canadian Task Force classification II-1).

University hospital.

Two thousand seventy-nine women undergoing outpatient hysteroscopy without analgesia.

Office hysteroscopy with a flexible or rigid hysteroscope and normal saline or CO(2).

Fifteen cases of vasovagal syndrome were reported. The rate of vasovagal syndrome was higher with use of a rigid hysteroscope (12/647 [1.85%]) vs. a flexible hysteroscope (3/1432 [0.21%]), p =.00013; p =.009 after adjustment for medium used; and with the use of CO2 (10/426 [2.34%]) vs. saline solution (5/1653 [0.30%]), p <.0001; p =.014 after adjustment for hysteroscope type.

Risk of vasovagal syndrome is higher with the use of a rigid hysteroscope and CO2, regardless of the indication for hysteroscopy or the parity and menopausal status of the patient.