Pain Perception After Office Hysteroscopy Alone vs. Hysteroscopy With Endometrial Biopsy [3E

Abstract

INTRODUCTION: Prior to performing office based gynecologic procedures, patients require appropriate preoperative counseling on anticipated pain. This study investigates the difference in patients’ pain perception when office hysteroscopy (OH) is performed alone compared with OH and concurrent endometrial biopsy (EMB). METHODS: A prospective study of patients presenting to USF for OH alone or OH with EMB between 10/2015 and 7/2016 was performed. Pre-procedure instructions were similar for all patients, and patients knew whether they were undergoing OH alone or OH with EMB. Patients described their pain perception using the visual analogue scale from 0-10 at the end of the procedure(s) and data was compared between groups using SPSS version 23. RESULTS: A total of 173 patients were enrolled in the study. Group 1 had OH alone (n=133) and group 2 had OH with EMB (n=40). Patients in group 1 were significantly younger than group 2 (36±6 vs 41±7, p-value less than 0.0001) but there was no significant difference in mean gravity or parity. Procedure indications included fibroids, endometrial polyps, fertility testing, and recurrent pregnancy loss. The median (range) global pain perception was 6 (0-10) vs 7 (0-10) between group 1 and 2 respectively, which was not significantly different (p=0.12). There was no difference in tenaculum use, uterine perforation or vasovagal reaction between the groups. CONCLUSION: Patient reported pain assessment was similar in women undergoing OH with or without endometrial biopsy. Similar preoperative instructions and preparation can be given to these patients.