Pain experienced during transvaginal ultrasound, saline contrast sonohysterography, hysteroscopy and office sampling: a comparative study.
OBJECTIVE
To evaluate and compare the pain experienced by women during transvaginal ultrasound, saline contrast sonohysterography (SCSH), diagnostic hysteroscopy and office sampling.


METHODS
This was a descriptive study of 402 consecutive patients presenting at a 'one-stop' Bleeding Clinic between October 2004 and November 2006. Thirty-nine percent of the patients were postmenopausal. The patients underwent the following examinations transvaginally: first ultrasound with color Doppler, second SCSH, third diagnostic hysteroscopy and fourth endometrial biopsy. After completion of the examinations the patients were asked to complete a questionnaire including a visual analog scale (VAS) about their subjective appreciation of all four examinations. Two-hundred and ninety-three (72%) patients returned the questionnaire.


RESULTS
The median (range) VAS scores for transvaginal ultrasound, SCSH, diagnostic hysteroscopy and endometrial sampling were 1.0 (0-8.1), 2.2 (0-10), 2.7 (0-10) and 5.1 (0-10), respectively (P < 0.0001). The patients' answers to the other questions about the pain experienced, including comparison with other minor procedures such as venous blood sampling, were all concordant with the VAS scores.


CONCLUSIONS
Transvaginal ultrasound was the procedure best accepted, followed by SCSH, hysteroscopy and endometrial sampling. These results suggest that patients would prefer SCSH over hysteroscopy as an initial diagnostic approach in the evaluation of abnormal uterine bleeding.
Van den Bosch
T
T
Department of Obstetrics & Gynaecology, University Hospitals, K.U.Leuven, Leuven, Belgium. thierry.van.den.bosch@skynet.be
Verguts
J
J
Daemen
A
A
Gevaert
O
O
Domali
E
E
Claerhout
F
F
Vandenbroucke
V
V
De Moor
B
B
Deprest
J
J
Timmerman
D
D
D000328:Adult; D000704:Analysis of Variance; D003287:Contrast Media; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000379:methods*; D008875:Middle Aged; D010146:Pain / Q000209:etiology* / Q000523:psychology; D010147:Pain Measurement; D017060:Patient Satisfaction; D017698:Postmenopause; D011446:Prospective Studies; D012965:Sodium Chloride; D011795:Surveys and Questionnaires; D014463:Ultrasonography; D014592:Uterine Hemorrhage / Q000175:diagnosis* / Q000523:psychology; D014599:Uterus / Q000000981:diagnostic imaging* / Q000473:pathology
D003287:Contrast Media; D012965:Sodium Chloride