title: Vaginal misoprostol versus a rectal nonsteroidal anti-inflammatory drug to reduce pain during Pipelle endometrial biopsies: a prospective, randomized, placebo-controlled trial.
abstract: BACKGROUND
  To evaluate and compare the efficacy of vaginal misoprostol and a rectal nonsteroidal anti-inflammatory drug (NSAID) on pain relief during Pipelle endometrial biopsies in a placebo-controlled randomized study.
  
  
  METHODS
  One hundred and fifty-one women who had an indication for a Pipelle endometrial biopsy were randomized into three groups as follows: group 1, vaginal misoprostol; group 2, rectal NSAID, and group 3, control. After the procedure, the women were asked to record their pain severity on a visual analog scale. The secondary outcome of the study was patient acceptability, and vasovagal symptoms and analgesic requirements after the procedure were also recorded.
  
  
  RESULTS
  There were no statistically significant differences in the demographic characteristics of the patients. The primary study outcome was the comparison of the median visual analog scale pain scores of groups 1 and 2 versus group 3 (controls); no statistically significant differences were found (p = 0.502). In addition, the patient acceptability (Likert scale), vasovagal symptoms and analgesic requirements after the procedure were similar among the groups (p = 0.204, 1 and 0.546, respectively).
  
  
  CONCLUSIONS
  Our study did not demonstrate a reduction in pain relief during Pipelle endometrial biopsies for patients receiving vaginal misoprostol or a rectal NSAID when compared to patients receiving placebo treatment.
authors.affiliation: Department of Obstetrics and Gynecology, Eskisehir Osmangazi University School of Medicine, Eskisehir, Turkey.
authors.forename: Elcin
authors.initials: E
authors.lastname: Telli
authors.forename: Yunus
authors.initials: Y
authors.lastname: Aydin
authors.forename: Tufan
authors.initials: T
authors.lastname: Oge
authors.forename: Omer Tarik
authors.initials: OT
authors.lastname: Yalcin
mesh_terms: D000282:Administration, Intravaginal; D000698:Analgesia / Q000379:methods*; D000700:Analgesics / Q000008:administration & dosage; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D001706:Biopsy / Q000295:instrumentation*; D004717:Endometrium / Q000473:pathology*; D005260:Female; D006801:Humans; D016595:Misoprostol / Q000008:administration & dosage*; D010147:Pain Measurement; D010919:Placebos; D011446:Prospective Studies; D012007:Rectum / Q000187:drug effects; D014621:Vagina / Q000187:drug effects
chemical_list: D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal; D010919:Placebos; D016595:Misoprostol