title: Evaluation of pain in outpatient diagnostic hysteroscopy with gas.
abstract: OBJECTIVE
  To evaluate the intensity of pain reported by patients undergoing outpatient diagnostic hysteroscopy.
  
  
  METHODS
  Exam performed with a 5-mm lens hysteroscope, vaginal speculum, tenaculum and uterine distention with carbon dioxide gas. Before and after the examination, patients were interviewed to define, in a verbal scale from 0 to 10, pain values that they expected to feel and that they experienced after the end, and also if they would repeat it if indicated. Data were analyzed using Statistical Package for the Social Sciences 15.0, statistic significance was defined as p < 0.05 with a study power of 95%.
  
  
  RESULTS
  Fifty-eight patients were included with mean age of 50.9 years, with 32.8% at postmenopause and 6.9% nulliparous. Among those with previous deliveries, mean parity was 2.21 and at least one vaginal delivery had occurred in 63.8%. Only 24.1% of patients knew how the exam would be done, 62.1% needed an endometrial sample and the result was considered satisfactory in 89.7%. The means of expected and experienced pain were similar (6.0 versus 6.1), and 91.4% of women would repeat the hysteroscopy if necessary. The only factor associated with less pain after the exam was previous vaginal delivery, with a decrease of pain score from 7.1 to 5.5 (p = 0.03). Mean pain was significantly lower in those who agreed to repeat the exam (5.8 versus 9.4; p = 0.003).
  
  
  CONCLUSIONS
  Outpatient diagnostic hysteroscopy with gas can be associated with moderate but tolerable discomfort and satisfactory results.
authors.affiliation: Department of Gynecology and Obstetrics, Hospital do Servidor Público Estadual "Francisco Morato de Oliveira" - HSPE-FMO, São Paulo, SP, Brazil.
authors.forename: Daniela Barreto Fraguglia Quental
authors.initials: DB
authors.lastname: Diniz
authors.affiliation: Endoscopic Gynecology Sector of Gynecology and Obstetrics Service, Hospital do Servidor Público Estadual de São Paulo "Francisco Morato de Oliveira" - HSPE-FMO, São Paulo, SP, Brazil.
authors.forename: Daniella de Batista
authors.initials: Dde B
authors.lastname: Depes
authors.affiliation: Department of Gynecology and Obstetrics, Hospital do Servidor Público Estadual "Francisco Morato de Oliveira" - HSPE-FMO, São Paulo, SP, Brazil.
authors.forename: Ana Maria Gomes Dos
authors.initials: AM
authors.lastname: Santos
authors.affiliation: Department of Gynecology and Obstetrics Service, Hospital do Servidor Público Estadual "Francisco Morato de Oliveria" - HSPE-FMO, São Paulo, SP, Brazil.
authors.forename: Simone Denise
authors.initials: SD
authors.lastname: David
authors.affiliation: Department of Gynecology and Obstetrics, Hospital do Servidor Público Estadual "Francisco Morato de Oliveria" - HSPE-FMO, São Paulo, SP, Brazil.
authors.forename: Salete
authors.initials: S
authors.lastname: Yatabe
authors.affiliation: Gynecology and Obstetrics Service, Hospital do Servidor Público Estadual "Francisco Morato de Oliveria" - HSPE-FMO, São Paulo, SP, Brazil.
authors.forename: Reginaldo Guedes Coelho
authors.initials: RG
authors.lastname: Lopes