title: A double-blind randomized controlled trial of vaginal misoprostol for cervical priming before outpatient hysteroscopy.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of vaginal misoprostol for cervical priming before diagnostic outpatient hysteroscopy (OH) without anesthesia.
  
  
  METHODS
  Double-blind randomized controlled trial.
  
  
  METHODS
  University teaching hospital.
  
  
  METHODS
  One hundred fifty patients requiring diagnostic OH for investigation of infertility or abnormal uterine bleeding in the reproductive age.
  
  
  METHODS
  Patients were randomly allocated into two equal groups (n = 75). In group I, 200 μg misoprostol was inserted into the posterior vaginal fornix 3 hours before OH; in group II (control), vaginal examination was performed without misoprostol administration. A rigid 30° 4-mm hysteroscope was used in the vaginoscopic technique.
  
  
  METHODS
  Ease of cervical entry (Likert scale), procedural time, patient acceptability (Likert scale), and pain scoring (visual analog scale).
  
  
  RESULTS
  Vaginal misoprostol significantly facilitated the procedure; cervical entry was easier, procedural time was shorter, patient acceptability was higher, and pain scoring was lower in group I compared with group II. Side effects of misoprostol were infrequent, minor, and transient. No complications were reported.
  
  
  CONCLUSIONS
  The regimen of 200 μg vaginal misoprostol administered 3 hours before diagnostic OH is a simple, effective, and safe method of cervical priming to facilitate the procedure without anesthesia.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt. dr_akmalelmazny@yahoo.com
authors.forename: Akmal
authors.initials: A
authors.lastname: El-Mazny
authors.forename: Nermeen
authors.initials: N
authors.lastname: Abou-Salem
mesh_terms: D000282:Administration, Intravaginal; D000328:Adult; D000553:Ambulatory Care / Q000379:methods*; D002584:Cervix Uteri / Q000187:drug effects* / Q000502:physiology; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000379:methods*; D007247:Infertility, Female / Q000175:diagnosis / Q000188:drug therapy; D016595:Misoprostol / Q000008:administration & dosage*; D010147:Pain Measurement / Q000187:drug effects / Q000379:methods; D055815:Young Adult
chemical_list: D016595:Misoprostol