Rectal Indomethacin Versus Rectal Diclofenac Sodium for Reducing Pain Associated with Diagnostic Office Hysteroscopy

Abstract

Background: Office hysteroscopy is a common surgical procedure but the optimal method of pain reduction is not known. Objectives: The objective of our study was to study the effect of rectal diclofenac sodium and indomethacin during diagnostic office hysteroscopy. Methods: This prospective study was conducted in Infertility and Reproductive Endocrinology Department of Istanbul University, Istanbul Faculty of Medicine, between December and March 2018. Indication of office hysteroscopy infertility or recurrent miscarriage which are included in the study. Patients received either 100 mg rectal indomethacin or diclofenac sodium one hour prior to office hysteroscopy. The patients who did not receive any medication formed the control group. End points included measures of pain among 30 patients in each group. Office hysteroscopy is performed. The perception of pain was evaluated for every subject during, immediately after, and 30 min after the office hysteroscopy with the use of the score on a visual analogue scale (VAS). One-way ANOVA test, Kruskal-Wallis test and χ2 test was performed for statistical analysis P value was < 0.05, the result was considered as statistically significant. Results: A total of Ninety patients were included in the study. The baseline characteristics of the three study groups were similar, except for mean gravidity. The gravidity was higher in the control group (P = 0.047) but the mean number of parity and number of normal vaginal births, which could affect the pain scores, were comparable between three groups. The duration of hysteroscopy was not statistically different in the study groups (P = 0.555). The study found no statistically significant difference in the pain scores among the groups during, immediately after, and 30 min after the procedure (P = 0.777, P = 0.774, P = 0.618, respectively). Conclusions: There is no statistically significant beneficial effect of either medication compared with any medication with regard to mean pain scores during and after diagnostic office hysteroscopy.