A randomised comparison of vaginoscopic office hysteroscopy and saline infusion sonography: a patient compliance study.
OBJECTIVE
The purpose of this study was to compare patient discomfort during saline infusion sonography (SIS) and office hysteroscopy performed according to a vaginoscopic approach.


METHODS
Randomised controlled trial.


METHODS
University hospital.


METHODS
Women with an indication for further investigation of the uterine cavity.


METHODS
A total of 100 women randomly allocated to either SIS or vaginoscopic office hysteroscopy in an outpatient clinic.


METHODS
Scores on a visual analogue scale (VAS) for pain and a present pain intensity (PPI) scale, conclusiveness and success rate.


RESULTS
The patients' pain scores on both the VAS and the PPI were lower for SIS when compared with office hysteroscopy (P < 0.05). However, in cases of severe pain (VAS > 7 or PPI > 2), there was no statistically significant difference between both groups. The success rate, defined as adequate inspection of the cervical canal and uterine cavity, was 94% for SIS compared with 92% for office hysteroscopy (P = 0.633). SIS, multiparity, shorter procedure time and position of the uterus in anteversion decreased pain scores among women studied.


CONCLUSIONS
Both SIS and office hysteroscopy are successful procedures and well tolerated by women. SIS induces significantly less discomfort than office hysteroscopy and should therefore be considered the method of choice.
van Dongen
H
H
Department of Gynaecology, Leiden University Medical Center, Leiden, the Netherlands. h.van_dongen@lumc.nl
de Kroon
C D
CD
van den Tillaart
S A H M
SA
Louwé
L A
LA
Trimbos-Kemper
G C M
GC
Jansen
F W
FW
D000328:Adult; D000553:Ambulatory Care; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D010146:Pain / Q000209:etiology*; D010147:Pain Measurement; D010349:Patient Compliance; D012044:Regression Analysis; D012965:Sodium Chloride / Q000008:administration & dosage*; D014463:Ultrasonography; D014591:Uterine Diseases / Q000000981:diagnostic imaging*
D012965:Sodium Chloride