How the Location of Intracavitary Lesions Influences Pain during Office Hysteroscopy

Abstract

Study objective: To assess how the location of intracavitary lesions during office hysteroscopy influences pain scores.

Design: Cohort study.

Setting: Department of Obstetrics and Gynecology, Hospital das Forças Armadas, Lisbon, Portugal.

Patients: Two hundred ninety-eight patients undergoing operative office hysteroscopy.

Interventions: Pain intensity was assessed by patients using a numeric rating scale (0-10) 10 minutes after hysteroscopy.

Measurements and main results: Statistical analysis assessed the association between pain score and clinical, obstetric, and gynecologic history. Associations with procedure-related factors were also assessed. Lesion location did not influence the perception of pain in the current sample. Hysteroscopic anesthesia allowed for a significant reduction in pain scores, regardless of lesion location. Multivariate analysis revealed that only the type of operative procedure and operating time significantly influenced pain scores.

Conclusion: Hysteroscopic anesthesia allows for a well-tolerated procedure, regardless of lesion location during office hysteroscopy. Lesion location should not be regarded as a technical limitation.

Keywords: Ambulatory hysteroscopy; Location; Operative hysteroscopy; Pain.