Abstract
Objective To compare CO 2 and normal saline as distention medium in diagnostic hysteroscopy. Design Prospective randomized study. Setting University-based artificial insemination and sterility center in Italy. Patient(s) Seventy-four women who underwent hysteroscopy. Intervention(s) Hysteroscopy was performed with CO 2 or normal saline. Main outcome measure(s) Quality of intrauterine images, cervical dilatation, local anesthesia, and duration of the test. In addition, each patient evaluated pain during and after the examination, irritation of the phrenic plexus, analgesic use, and side effects. Result(s) The quality of the hysteroscopic image was statistically similar for both media. Dilatation of the cervical canal and use of local anesthesia was more often necessary in the CO 2 group. The procedure time was 5.96 ± 1.55 minutes in the CO 2 group and 3.12 ± 0.96 in the normal saline group. The CO 2 group reported pain more frequently during and after the examination, shoulder pain, greater analgesic use, and more side effects. Conclusion(s) For hysteroscopy, normal saline is technically equal to CO 2 in terms of image quality and ease of use but offers more advantages. Hysteroscopy with normal saline is more acceptable to patients, quicker to perform, and entails fewer additional procedures.
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