Abstract
ABSTRACTObjective To determine whether a 3.1‐mm diameter flexible hysteroscope causes less patient discomfort and requirement for cervical dilatation than a 3.6‐mm hysteroscope.Setting The outpatient hysteroscopy clinic of a large teaching hospital in the UK.Participants 159 women with abnormal uterine bleeding who required an outpatient hysteroscopy.Design and intervention A cohort of patients undergoing hysteroscopy with a 3.6‐mm hysteroscope was matched for age, parity and menopausal status with a cohort of patients undergoing hysteroscopy with a 3.1‐mm hysteroscope.Main outcome measures Pain scores using a 10‐cm visual analogue scale, and women's description of pain using a Likert‐scale question.Results Significantly more postmenopausal women undergoing a 3.6‐mm required dilatation of the cervical canal compared with those undergoing a 3.1‐mm hysteroscopy (P = 0.02). In both the premenopausal and postmenopausal groups significantly more women undergoing a 3.1‐mm hysteroscopy had a pain score of zero compared with those undergoing a 3.6‐mm hysteroscopy. In the postmenopausal cohort significantly fewer women in the 3.1‐mm group (31% compared with 51% in the 3.6‐mm group) had pain scores of more than three (P = 0.007). There were also significantly more postmenopausal women in the 3.1‐mm group (64% compared with 23% in the 3.6‐mm group) who described either mild pain or no pain whatsoever (P = 0.0003).Conclusion Decreasing the diameter of the device used in flexible hysteroscopy from 3.6 mm to 3.1 mm results in a significant reduction in pain and discomfort for both premenopausal and postmenopausal women and significantly reduces the requirement for cervical dilatation in postmenopausal women.
Published Version
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