Are there possible predictors of pain during office hysteroscopy among infertile women in Port Harcourt Nigeria?

Abstract

Context: Invasive office procedures such as office hysteroscopy are usually carried out without analgesia as they are thought to cause minimal or no pain to the patient. Hysteroscopy has been found to be a cause of significant pain in some patients. Aims: To determine factors inherent in infertile patients experiencing pain during office hysteroscopy in Port Harcourt, Nigeria. Settings and Design: A cross-sectional comparative study amongst infertile women undergoing office hysteroscopy. Methods and Material: Assessment of Pain perceptions using a numerical pain scale in 101 women following office hysteroscopy. Demographic, Social, and gynecological factors of these patients were analysed for association with to pain perception. Statistical Analysis Used: Bivariate logistic regression analysis was conducted for associations between pain perception and suspected factors with P≤ 0.05 as statistically significant. Results: The mean age of the patients was 35.95±4.65 years. 53(52.5%) and 48(47.5%) of the patients experienced moderate/severe pain and mild/no pain respectively. Moderate/severe pain in participants was not associated with age, parity, type or period of infertility, dysmenorrhea or previous pregnancy terminations. However, it was associated with education below secondary level (OR=1.82; P value=0.21, 95%CI 0.81-4.11) and over one previous miscarriages (OR=1.11, P value = 0.948.;95% CI 0.51-2.43). Conclusions: Moderate/severe pains at office hysteroscopy occurred in more than one half of the patients increased risk of pain occurred in patients with miscarriages and those with less than secondary education. We recommend analgesia for patients undergoing office hysteroscopy.