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A randomised comparison of vaginoscopic office hysteroscopy and saline infusion sonography: a patient compliance
H van Dongen1, C D de Kroon, S A H M van den Tillaart
1Department of Gynaecology, Leiden University Medical Center, Leiden, the Netherlands. h.van_dongen@lumc.nl
Objective:
The purpose of this study was to compare patient discomfort during saline infusion sonography (SIS) and office hysteroscopy performed according to a vaginoscopic approach.
Design:
Randomised controlled trial.
Setting:
University hospital.
Population:
Women with an indication for further investigation of the uterine cavity.
Methods:
A total of 100 women randomly allocated to either SIS or vaginoscopic office hysteroscopy in an outpatient clinic.
Main Outcome Measures:
Scores on a visual analogue scale (VAS) for pain and a present pain intensity (PPI) scale, conclusiveness and success rate.
Results:
The patients' pain scores on both the VAS and the PPI were lower for SIS when compared with office hysteroscopy (P < 0.05). However, in cases of severe pain (VAS > 7 or PPI > 2), there was no statistically significant difference between both groups. The success rate, defined as adequate inspection of the cervical canal and uterine cavity, was 94% for SIS compared with 92% for office hysteroscopy (P = 0.633). SIS, multiparity, shorter procedure time and position of the uterus in anteversion decreased pain scores among women studied.
Conclusions:
Both SIS and office hysteroscopy are successful procedures and well tolerated by women. SIS induces significantly less discomfort than office hysteroscopy and should therefore be considered the method of choice.
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