Impact of Uterine Scar on Pain Experienced During Outpatient Hysteroscopy: A Prospective Blinded Comparative Study

Abstract

Study ObjectiveTo study the impact of uterine scar on pain experienced during outpatient hysteroscopy. DesignA prospective blinded comparative study (Canadian Task Force classification II-1). SettingOutpatient hysteroscopy clinic at a university hospital. PatientsWe included 140 women in the childbearing period attending an outpatient hysteroscopy clinic. Patients were divided into 2 groups. Group A included patients with previous uterine scar (n = 70) and Group B included those with unscarred uterus (n = 70). None of the patients had a previous attempt of a vaginal delivery. InterventionDiagnostic outpatient hysteroscopy without the use of anesthesia or analgesia. MeasurementsWe assessed pain experienced during and immediately after the procedure using a 100-mm visual analog scale. We also evaluated the successful completion of the procedure. ResultsThere were no statistically significant differences in the pain scores between patients with scarred uterus and those with unscarred uterus during or immediately after the procedure. The procedure was aborted in only 1 case in the scarred uterus group. This patient had a history of surgical site infection, which may denote a weak scar. There were no statistically significant differences in pain scores between patients with cesarean scar and those with myomectomy scar. No statistically significant differences in pain scores were found between patients with 1, 2, 3, or 4 cesarean deliveries. ConclusionUncomplicated uterine scars do not have an impact on pain experienced during or immediately after diagnostic outpatient hysteroscopy using a 3.8-mm hysteroscope.