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Archives of Gynecology and Obstetrics

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01-11-2015 | Review

Is pain better tolerated with mini-hysteroscopy than with conventional device? A systematic review and meta-analysis

Hysteroscopy scope size and pain

Authors: Antonio Augusto Santos Paulo, Maria Helena Ruivo Solheiro, Carolina Oliveira Santos Paulo

Published in: Archives of Gynecology and Obstetrics | Issue 5/2015

Abstract

Background

Hysteroscopy is an indispensable approach in gynecology. Miniaturization may reduce pain allowing office procedures without anesthesia.

Objectives

Our main objective is to determine if modifications in scope diameters have made office hysteroscopy less painful.

Search strategy

Studies were sought with key words “hysteroscopy” and “pain” from available online sources. Time frame was from 2000 onward. Thirty-three articles were retrieved for detailed analysis.

Selection criteria

Prospective randomized trials, studying pain as main outcome in office hysteroscopy expressed in means, confidence intervals and SD, comparing office mini-hysteroscopy to conventional hysteroscopy. Studies or arms within a study where conscientious sedation, anesthesia or non-steroidal drugs were used were excluded.

Data collection and analysis

We analyzed data from eight studies (seven RCT) comparing mini-hysteroscopy with conventional scopes, involving a total of twenty-three hundred and twenty-two participants, of which nineteen hundred and eighty-six completed the intervention.

Main results

A meta-analysis revealed a significant reduction pain score (MD: −3.64; 95 % CI −5.16 to −2.12; test for overall effect p < 0.00001) and available data support miniaturization decreases pain in outpatient hysteroscopy.

Conclusions

Pain in office hysteroscopy is lower with mini-hysteroscopes.

Review manager (RevMan) [Computer Program]. Version 5.0. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration (2008).

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10.

Dealberti D et al (2013) New mini-resectoscope: analysis of preliminary quality results in outpatient hysteroscopic polypectomy. Arch Gynecol Obstet 288(2):349–353CrossRefPubMed

11.

Romani F et al (2013) The use of different size-hysteroscope in office hysteroscopy: our experience. Arch Gynecol Obstet 288(6):1355–1359CrossRefPubMed

12.

Lagana AS et al (2014) 3D sonohysterography vs hysteroscopy: a cross-sectional study for the evaluation of endouterine diseases. Arch Gynecol Obstet 290(6):1173–1178CrossRefPubMed

13.

Yang R et al (2014) The hysteroscopy and histological diagnosis and treatment value of chronic endometritis in recurrent implantation failure patients. Arch Gynecol Obstet 289(6):1363–1369CrossRefPubMed

14.

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15.

Unfried G et al (2001) Flexible versus rigid endoscopes for outpatient hysteroscopy: a prospective randomized clinical trial. Hum Reprod 16(1):168–171CrossRefPubMed

16.

Raimondo G et al (2010) A randomized controlled study comparing carbon dioxide versus normal saline as distention media in diagnostic office hysteroscopy: is the distension with carbon dioxide a problem? Fertil Steril 94(6): 2319–2322CrossRefPubMed

17.

Cooper NA et al (2011) A systematic review of the effect of the distension medium on pain during outpatient hysteroscopy. Fertil Steril 95(1):264–271CrossRefPubMed

18.

De Angelis C et al (2003) Suppression of pelvic pain during hysteroscopy with a transcutaneous electrical nerve stimulation device. Fertil Steril 79(6):1422–1427CrossRefPubMed

19.

Angioli R et al (2014) Use of music to reduce anxiety during office hysteroscopy: prospective randomized trial. J Minim Invasive Gynecol 21(3):454–459CrossRefPubMed

20.

Floris S et al (2007) Efficacy of intravenous tramadol treatment for reducing pain during office diagnostic hysteroscopy. Fertil Steril 87(1):147–151CrossRefPubMed

21.

Lin YH et al (2005) Use of sublingual buprenorphine for pain relief in office hysteroscopy. J Minim Invasive Gynecol 12(4):347–350CrossRefPubMed

22.

Campo R, Molinas CR, Rombauts L, Mestdagh G, Lauwers M, Braekmans P et al (2005) Prospective multicentre randomized controlled trial to evaluate factors influencing the success rate of office diagnostic hysteroscopy. Hum Reprod 20(1):258–263CrossRefPubMed

23.

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24.

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25.

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27.

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29.

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30.

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31.

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32.

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33.

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34.

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35.

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36.

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37.

Kassem A, El-Brombly W (2005) Outpatient minihysteroscopy and conventional hysteroscopy: a comparative study. Middle East Fertil Society J 10(3):231–237

38.

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39.

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Title: Is pain better tolerated with mini-hysteroscopy than with conventional device? A systematic review and meta-analysis
Hysteroscopy scope size and pain
Authors: Antonio Augusto Santos Paulo
Maria Helena Ruivo Solheiro
Carolina Oliveira Santos Paulo
Publication date: 01-11-2015
Publisher: Springer Berlin Heidelberg
Published in: Archives of Gynecology and Obstetrics / Issue 5/2015
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-015-3731-0

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Is pain better tolerated with mini-hysteroscopy than with conventional device? A systematic review and meta-analysis

Hysteroscopy scope size and pain

Abstract

Background

Objectives

Search strategy

Selection criteria

Data collection and analysis

Main results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Objectives

Search strategy

Selection criteria

Data collection and analysis

Main results

Conclusions

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