title: Carbon dioxide versus normal saline as a uterine distension medium for diagnostic vaginoscopic hysteroscopy in infertile patients: a prospective, randomized, multicenter study.
abstract: OBJECTIVE
  To evaluate the satisfaction rate, efficacy, and complication rate of carbon dioxide (CO(2)) versus normal saline as a uterine distension medium for outpatient diagnostic vaginoscopic hysteroscopy in infertile patients.
  
  
  METHODS
  Prospective, randomized multicenter study.
  
  
  METHODS
  Hysteroscopy units in two university hospitals and in a private center.
  
  
  METHODS
  One hundred eighty-nine infertile women undergoing outpatient hysteroscopy.
  
  
  METHODS
  Outpatient hysteroscopy was performed with CO(2) (group A) or normal saline (group B) and with endometrial biopsy when indicated.
  
  
  METHODS
  Quality of the visualization of the uterine cavity, procedure time, complications, patient discomfort, and satisfaction rate.
  
  
  RESULTS
  Significantly lower abdominal and shoulder tip pain and a lower incidence of vasovagal reactions were observed in group B in comparison with group A. A higher satisfaction rate and a lower operative time were obtained in the normal saline group in comparison with the CO(2) group. Moreover, group A required significantly more analgesics after the procedure than group B.
  
  
  CONCLUSIONS
  Uterine distension with normal saline seems to have less adverse effects and is better tolerated by patients. Moreover, it allows operative procedures to be performed with the new bipolar instruments.
authors.affiliation: Department of Obstetrics and Gynecology, University of Naples Federico II., Italy. pellican@unina.it
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Pellicano
authors.forename: Maurizio
authors.initials: M
authors.lastname: Guida
authors.forename: Fulvio
authors.initials: F
authors.lastname: Zullo
authors.forename: Giada
authors.initials: G
authors.lastname: Lavitola
authors.forename: Domenico
authors.initials: D
authors.lastname: Cirillo
authors.forename: Carmine
authors.initials: C
authors.lastname: Nappi
mesh_terms: D002245:Carbon Dioxide / Q000009:adverse effects; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000009:adverse effects / Q000379:methods*; D010146:Pain; D010149:Postoperative Pain / Q000453:epidemiology; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012965:Sodium Chloride / Q000009:adverse effects; D017211:Treatment Failure; D014599:Uterus / Q000187:drug effects / Q000502:physiology* / Q000601:surgery; D014621:Vagina / Q000473:pathology*
chemical_list: D002245:Carbon Dioxide; D012965:Sodium Chloride