The effect of uterocervical angle intervention on pain in retrovertion uterus: Evaluation of suprapubic compression: A retrospective observational study

This study aims to identify the factors affecting pain perception during office hysteroscopy and to evaluate the impact of suprapubic pressure on pain levels. In this retrospectively designed study, patients undergoing office-based "no-touch" hysteroscopy were evaluated. Participants were divided into 2 groups based on their pain scores using the Visual Analog Scale (VAS): VAS < 4 (low pain) and VAS ≥ 4 (high pain). Patient age, cervical canal passage time, presence of suprapubic pressure for uterocervical angle correction, and other demographic and clinical variables were analyzed. A significantly higher VAS score was observed in older patients and those with prolonged cervical canal passage time (P < .05). Contrary to expectations, pain scores were higher in the group where suprapubic pressure was applied. While a positive correlation was found between cervical passage time and VAS score, no significant relationship was detected between cervical canal length and VAS score. The most influential factor on pain perception during office hysteroscopy appears to be cervical canal passage time. Advanced age and increased difficulty in cervical access contribute to higher pain levels. Although suprapubic pressure may be applied to correct the uterocervical angle, it may increase discomfort due to its subjective nature. Therefore, pharmacological support may be considered for elderly patients, and future studies should aim to standardize pain-reducing interventions.