title: The effect of preprocedure anxiety levels on postprocedure pain scores in women undergoing hysterosalpingography.
abstract: BACKGROUND
  Hysterosalpingography (HSG) is an invasive, uncomfortable, and painful procedure. Patients often experience considerable anxiety and stress before the procedure. In this study, we aimed to evaluate the effect of preprocedure anxiety on postprocedure pain scores and clinical outcomes in women undergoing HSG.
  
  
  METHODS
  This study was designed as a prospective randomized study. Women undergoing HSG were asked to complete the Beck Anxiety Inventory before the procedure. Patients were classified into two groups according to the anxiety score (Group 1: anxiety score ≤ 25; n = 84 and Group 2: anxiety score > 25, n = 25). All of the patients were asked to state the severity of their pain during the procedure using a visual analogue scale immediately after the procedure. Then, postprocedure pain scores and clinical features were evaluated. Data analyzed were: age, gravidity, parity, durations of marriage and infertility, body mass index, procedure time, amount of contrast media used, operator sex, history of surgery, educational level, and HSG results.
  
  
  RESULTS
  A total of 109 women were enrolled into this prospective study. There was no statistically significant difference between the groups in terms of age, body mass index, durations of marriage and infertility, procedure time, amount of contrast media used, operator sex, history of surgery, educational level, and patency of the one and/or two fallopian tubes (p > 0.05). The median parity and pain scores after the procedure were lower in Group 1 (p < 0.05). There was also a positive correlation between anxiety scores and postprocedure pain scores (r = 0.289, p = 0.002). Receiver operator characteristics curve analysis demonstrated that operator sex was an important risk factor for postprocedure pain in patients with a preprocedure Beck Anxiety Inventory > 25. Logistic regression method demonstrated that higher parity, preprocedure anxiety score > 25, and male operator were risk factors for increased postprocedure visual analogue scale scores.
  
  
  CONCLUSIONS
  According to this study, preprocedure anxiety levels have an effect on postoperative pain scores in women undergoing HSG procedure. Multiparity, male operator, and higher preprocedure anxiety scores also may have an effect on postoperative pain scores.
authors.affiliation: Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Research and Education Hospital, Ankara, Turkey. Electronic address: aytekintokmak@gmail.com.
authors.forename: Aytekin
authors.initials: A
authors.lastname: Tokmak
authors.affiliation: Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Research and Education Hospital, Ankara, Turkey.
authors.forename: Mahmut Kuntay
authors.initials: MK
authors.lastname: Kokanali
authors.affiliation: Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Research and Education Hospital, Ankara, Turkey.
authors.forename: Ali İrfan
authors.initials: Aİ
authors.lastname: Güzel
authors.affiliation: Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Research and Education Hospital, Ankara, Turkey.
authors.forename: Ümit
authors.initials: Ü
authors.lastname: Taşdemir
authors.affiliation: Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Research and Education Hospital, Ankara, Turkey.
authors.forename: Burak
authors.initials: B
authors.lastname: Akselim
authors.affiliation: Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Research and Education Hospital, Ankara, Turkey.
authors.forename: Nafiye
authors.initials: N
authors.lastname: Yilmaz
mesh_terms: D001007:Anxiety / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007047:Hysterosalpingography / Q000523:psychology*; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology*; D010298:Parity; D011247:Pregnancy; D011446:Prospective Studies; D064232:Visual Analog Scale
keywords: beck anxiety inventory; hysterosalpingography; multiparity; operator sex; visual analogue scale