Office Hysteroscopy
Introduction
Office hysteroscopy is the golden standard for detection of intrauterine abnormalities. Office hysteroscopy is a simple, safe, effective procedure that can be performed in outpatient setting without the need for operating theatre facilities or general or regional anesthesia [1-3]. Although office hysteroscopy is well tolerated by the majority of patient, some patients may experience severe or intolerable pain[4-5].
Several studies revealed that parity, menopausal state, history of cesarean section, scope diameter, operator’s experience and patient anxiety are the main determinants for pain experienced during office hysteroscopy[6-7]. Severe or intolerable pain is more frequent in the subgroups of patients with narrow cervical …show more content…
Analgesics (opioid and non-opioid), topical anesthetics and transcutaneous electrical nerve stimulation were used to minimize perception of pain. Moreover, prostaglandins and mifepristone were used to soften and widen the cervical canal to allow easy and painless passage of the hysteroscope through the cervical canal. Studies examining the effectiveness of these treatments in relieving pain during office hysteroscopy have produced contradictory results and no solid conclusion on the safest and the most effective method for pain relief during office hysteroscopy was reached [4, 14 …show more content…
The use of misoprostol prior to operative hysteroscopy is associated with easier dilatation of cervix, shorter operative time and less risk of cervical injury, creation of false track and uterine perforation[1-2].Several studies investigated the role of misoprostol in minimizing the pain experienced during office hysteroscopy but the results were non-conclusive. Moreover, these studies either enrolled only patients with risk factors for cervical stenosis (nulliparous or menopausal patients ) or enrolled heterogeneous population of patients (with and without risk factors for cervical stenosis)[1,4]. Till now, no studies have yet investigated the benefits and risks of misoprostol administration prior to office hysteroscopy in the subgroup of patients with no risk factors for cervical stenosis (i.e. parous women of reproductive age who have no history of cesarean section or cervical
Office hysteroscopy is the golden standard for detection of intrauterine abnormalities. Office hysteroscopy is a simple, safe, effective procedure that can be performed in outpatient setting without the need for operating theatre facilities or general or regional anesthesia [1-3]. Although office hysteroscopy is well tolerated by the majority of patient, some patients may experience severe or intolerable pain[4-5].
Several studies revealed that parity, menopausal state, history of cesarean section, scope diameter, operator’s experience and patient anxiety are the main determinants for pain experienced during office hysteroscopy[6-7]. Severe or intolerable pain is more frequent in the subgroups of patients with narrow cervical …show more content…
Analgesics (opioid and non-opioid), topical anesthetics and transcutaneous electrical nerve stimulation were used to minimize perception of pain. Moreover, prostaglandins and mifepristone were used to soften and widen the cervical canal to allow easy and painless passage of the hysteroscope through the cervical canal. Studies examining the effectiveness of these treatments in relieving pain during office hysteroscopy have produced contradictory results and no solid conclusion on the safest and the most effective method for pain relief during office hysteroscopy was reached [4, 14 …show more content…
The use of misoprostol prior to operative hysteroscopy is associated with easier dilatation of cervix, shorter operative time and less risk of cervical injury, creation of false track and uterine perforation[1-2].Several studies investigated the role of misoprostol in minimizing the pain experienced during office hysteroscopy but the results were non-conclusive. Moreover, these studies either enrolled only patients with risk factors for cervical stenosis (nulliparous or menopausal patients ) or enrolled heterogeneous population of patients (with and without risk factors for cervical stenosis)[1,4]. Till now, no studies have yet investigated the benefits and risks of misoprostol administration prior to office hysteroscopy in the subgroup of patients with no risk factors for cervical stenosis (i.e. parous women of reproductive age who have no history of cesarean section or cervical