JOURNAL ARTICLE
RANDOMIZED CONTROLLED TRIAL
Add like
Add dislike
Add to saved papers

Effectiveness of vaginal misoprostol and rectal nonsteroidal anti-inflammatory drug in vaginoscopic diagnostic outpatient hysteroscopy in primarily infertile women: double-blind, randomized, controlled trial.

STUDY OBJECTIVE: To assess whether vaginally administered misoprostol or rectally administered nonsteroidal anti-inflammatory drug reduces pain during vaginoscopic diagnostic outpatient hysteroscopy in nulliparous infertile patients.

DESIGN: Double-blinded, randomized, controlled trial (Canadian Task Force classification I).

SETTING: Department of reproductive medicine at a university teaching hospital.

PATIENTS: One hundred fifty-eight primarily infertile women who underwent outpatient hysteroscopy for evaluation of infertility.

INTERVENTIONS: Patients were randomly assigned to 3 groups. Women in group 1 received 200 μg misoprostol vaginally at 6 hours before outpatient hysteroscopy and placebo tablets rectally at 60 minutes before the procedure. Women in group 2 received placebo tablets rectally at 6 hours before outpatient hysteroscopy and 100 mg diclofenac sodium rectally at 60 minutes before the procedure. Women in group 3 received placebo tablets vaginally at 6 hours before outpatient hysteroscopy and placebo tablets rectally at 45 to 60 minutes before the procedure. Patients were asked to record severity of pain, which was the primary outcome of the study, during the outpatient hysteroscopy procedure by using a visual analog scale ranging from 1 (very favorable) to 10 (very unfavorable). Secondary outcomes included procedural time from introduction of the hysteroscope through the external cervical os and visualization of the uterine cavity, patient acceptance recorded by the patient using a 5-point Likert scale, post-procedural analgesic requirements, and vasovagal effects.

MEASUREMENTS AND MAIN RESULTS: Median (range) pain scores for the women in group 1 (4.75 [3.12-6.54]) and group 2 (5.01 [2.8-7.05]) were not significantly different from those in group 3 (4.15 [2.17-6.92]) (p = .57). There was also no significant difference in patient acceptance (Likert scale) (p = .67), vasovagal symptoms (p = .84), procedure time (p = .05), and post-procedural analgesic requirement (p = .71).

CONCLUSIONS: We were unable to demonstrate a benefit in pain reduction and patient acceptance with the use of vaginal misoprostol or rectal NSAIDs during vaginoscopic diagnostic outpatient hysteroscopy in nulliparous infertile women without a history of cervical stenosis. Trials investigating the optimal time for vaginal misoprostol premedication for pain relief in vaginoscopic outpatient hysteroscopy are needed. New interventions and/or drugs should be studied to decrease pain perception during vaginoscopic outpatient hysteroscopy.

Full text links

We have located links that may give you full text access.
Can't access the paper?
Try logging in through your university/institutional subscription. For a smoother one-click institutional access experience, please use our mobile app.

For the best experience, use the Read mobile app

Mobile app image

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app

All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

By using this service, you agree to our terms of use and privacy policy.

Your Privacy Choices Toggle icon

You can now claim free CME credits for this literature searchClaim now

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app