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Randomised comparison of distension media for outpatient hysteroscopy

  1. Meena Shankar1,
  2. Allan Davidson1,
  3. Nick Taub2,
  4. Marwan Habiba1,3,*

Article first published online: 15 DEC 2003

DOI: 10.1046/j.1471-0528.2003.00004.x

Issue

BJOG: An International Journal of Obstetrics & Gynaecology

BJOG: An International Journal of Obstetrics & Gynaecology

Volume 111, Issue 1, pages 57–62, January 2004

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How to Cite

Shankar, M., Davidson, A., Taub, N. and Habiba, M. (2004), Randomised comparison of distension media for outpatient hysteroscopy. BJOG: An International Journal of Obstetrics & Gynaecology, 111: 57–62. doi: 10.1046/j.1471-0528.2003.00004.x

Author Information

  1. 1

    Department of Obstetrics and Gynaecology, Leicester Royal Infirmary, UK

  2. 2

    Department of Epidemiology and Public Health, University of Leicester, UK

  3. 3

    Department of Obstetrics and Gynaecology, University of Leicester, UK

* *: Mr M. Habiba, Department of Obstetrics and Gynaecology, University of Leicester, Leicester Royal Infirmary, Robert Kilpatrick Clinical Sciences Building, PO Box 65 Leicester LE2 7LX, UK.

Publication History

  1. Issue published online: 15 DEC 2003
  2. Article first published online: 15 DEC 2003

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Objective  To compare saline with and without added lignocaine and carbon dioxide distension for out patient hysteroscopy with regards to patient discomfort and hysteroscopic view.

Design  Single blind prospective randomised controlled trial.

Setting  Specialist out patient clinics in a large teaching hospital.

Population  Women undergoing out patient hysteroscopy and endometrial biopsy for abnormal uterine bleeding.

Method  Out patient hysteroscopy using carbon dioxide, saline or saline with lignocaine.

Main outcome measures  Visual analogue score (VAS) for pain and present pain intensity (PPI) as assessed by patients and the quality of hysteroscopic view as assessed by the operator.

Results  Of the 305 women approached, 300 women were randomised into the study. The mean [SD] VAS for pain in the carbon dioxide group was 2.9 [2.3] and in the saline group was 3.1 [2.6], the difference was not statistically significant (P= 0.49). The mean [SD] VAS for pain in the saline plus lignocaine group was 3.2 [2.4]. This was not significantly different from the saline group (P= 0.72). There was a statistically significant difference between the confidence rating for the hysteroscopic view for the carbon dioxide compared with the saline group; mean [SD] was 8.3 [2.1] and 9.6 [1.1], respectively (P= 0.001).

Conclusion  Carbon dioxide and saline as distension media are comparable in terms of overall patient discomfort and satisfaction, but saline provides better views and increases confidence in diagnosis. Adding lignocaine to the saline distension medium does not confer any additional benefit.

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