Transcutaneous electrical nerve stimulation can reduce pain during diagnostic hysteroscopy and endometrial biopsy: a randomized, controlled trial

Abstract

To assess the effectiveness of Transcutaneous Electrical Nerve Stimulation (TENS) to relieve pain during office diagnostic histeroscopy and endometrial biopsy. Randomized, controlled trial. Between August 2012 and February 2013, 40 women that would be submitted to office diagnostic hysteroscopy and endometrial biopsy were randomized in two groups. In group I, they were submitted to application of TENS with Tanyx® in infra-umbilical area during the procedure. In group 2, women were forwarded straight to hysteroscopy. All procedures were performed using a semi-rigid 3.5mm minihysteroscope with a 30 degrees grade optic, followed to endometrial biopsy with Novak curette. Women were asked to rate their degree of pain during the two phases (hysteroscopy and biopsy) according to a VAS (visual analogic scale) ranging from 0 to 10, where 0 was “no pain” and 10 was “unbearable pain”. The variables were compared using t Student test. In group which received TENS, women related significantly lower level of pain than patients which did not both during diagnostic hysteroscopy (5.80 ± 2.19 vs. 2.30 ± 1.34, p=0.0001) and endometrial biopsy (4.70 ± 1.53 vs. 7.95 ± 1.93, p=0001). TENS can relieve pain during office diagnostic hysteroscopy and may be an useful tool to reduce the burden of these procedures. Nevertheless, larges trials which neutralize the placebo effect are necessary to confirm its real efficacy.