Pain during diagnostic hysteroscopy: what is the role of the cervical canal? A pilot study

Abstract Objective To evaluate whether a correlation exists between the pain perceived during diagnostic anesthesia-free hysteroscopy and the characteristics of the cervical canal. Study design Prospective observational pilot study of 255 women undergoing diagnostic hysteroscopy. Data analysis inclu...

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Bibliographic Details
Published in:European journal of obstetrics & gynecology and reproductive biology 2014-12, Vol.183, p.169-173
Main Authors: Mazzon, Ivan, Favilli, Alessandro, Horvath, Stefano, Grasso, Mario, Di Renzo, Gian Carlo, Laurenti, Elena, Bini, Vittorio, Gerli, Sandro
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Cervical canal
Cervical synechiae
Cervix Uteri - anatomy & histology
Diagnostic hysteroscopy
Female
Humans
Hysteroscopy - adverse effects
Logistic Models
Middle Aged
Multivariate Analysis
Obstetrics and Gynecology
Office hysteroscopy
Pain
Pain - diagnosis
Pain - etiology
Pain Measurement
Parity
Pilot Projects
Prospective Studies
Risk Factors
VAS
Young Adult
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Summary:Abstract Objective To evaluate whether a correlation exists between the pain perceived during diagnostic anesthesia-free hysteroscopy and the characteristics of the cervical canal. Study design Prospective observational pilot study of 255 women undergoing diagnostic hysteroscopy. Data analysis included characteristics of the patient and the cervical canal, and the pain experience during the procedure, assessed by visual analog score (VAS). A multiple logistic regression was then carried out in order to exclude confounding factors. Results The degree of pain during hysteroscopy was equal to a median VAS score of 2 (range 0–10). Bivariate analysis between patients with VAS > 3 and patients with VAS ≤ 3 demonstrated a significant correlation between pain and the presence of synechiae in the cervical canal ( P = 0.022), the patient's age ( P = 0.003) and parity ( P = 0.001). Multivariate analysis revealed that the presence of cervical synechiae ( P = 0.0001) [OR = 4.99 (95% CI 2.13–11.70)] and parity ( P = 0.014) [OR = 0.42 (95% CI 0.21–0.83)] were significantly correlated with pain. There was no significant correlation with the different angles of the cervical canal. Conclusion Cervical synechiae appear as a major factor influencing pain during hysteroscopy. While parity acts as a protective factor, the angle of the cervical canal does not seem to play an important role for pain during diagnostic hysteroscopy.
ISSN:0301-2115
1872-7654
DOI:10.1016/j.ejogrb.2014.10.045