Diagnostic office hysteroscopy; why is it still painful procedure despite the surgical experience and mini-hysteroscope?

dc.authorid0000-0003-4175-7694
dc.authorscopusid45661486100
dc.authorscopusid56521227200
dc.authorscopusid55220857500
dc.authorscopusid57481795000
dc.authorscopusid55194255000
dc.authorscopusid55859789400
dc.authorscopusid57482269300
dc.authorwosidKaya, Cihan/AAM-3929-2020
dc.contributor.authorGüraslan, Hakan
dc.contributor.authorŞentürk, Mehmet B.
dc.contributor.authorDoğan, Keziban
dc.contributor.authorYüksel, Berkay
dc.contributor.authorKaya, Cihan
dc.contributor.authorKaracan, Tolga
dc.contributor.authorCeylan, Yasin
dc.date.accessioned2022-05-11T14:04:55Z
dc.date.available2022-05-11T14:04:55Z
dc.date.issued2022
dc.departmentFakülteler, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Kadın Hastalıkları ve Doğum Ana Bilim Dalı
dc.description.abstractAim To evaluate the effect of cervical canal features on pain during outpatient hysteroscopy performed by experienced surgeons using mini-hysteroscope. Methods A prospective observational study was conducted on 303 women undergoing diagnostic hysteroscopy without anesthesia. Pain intensity was evaluated using the visual analog scale (VAS) when the cervical canal was passed. The patients were divided into two groups according to the VAS score: painless or mild pain (VAS <4) and moderate or severe pain (VAS >= 4). The relationship between cervical canal characteristics (length, version, and flexion positions, history of cervical intervention, stenosis, synechiae), obstetric and gynecological history, preoperative anxiety level, procedure duration, and pain intensity was examined. Results Moderate pain (4 <= VAS < 7) was observed in 38% of patients (n = 117) and 14 patients (5%) experienced severe pain (VAS >= 7). In multivariate analysis, nulliparity (p = 0.01; OR, 4.6; 95% CI, 1.7-13.2), postmenopausal state (p = 0.02; OR, 2.2; 95% CI, 1.2-4.3), excessive flexion of the cervix and retroverted uterus (p <0.001; OR, 4.1; 95% CI, 2.0-8.5) were identified as risk factors for a painful procedure. Diagnostic hysteroscopy was successful in 98% of the patients. The pain was the primary cause of the failed hysteroscopy. Conclusion In addition to nulliparity and postmenopausal status, unfavorable features of the cervical canal, such as the excessive flexion position of the cervix and uterine retroversion are significant causes of pain during outpatient hysteroscopy.
dc.identifier.doi10.1111/jog.15219
dc.identifier.issn1341-8076
dc.identifier.issn1447-0756
dc.identifier.pmid35274418
dc.identifier.scopus2-s2.0-85126022629
dc.identifier.scopusqualityQ2
dc.identifier.urihttps://doi.org/10.1111/jog.15219
dc.identifier.urihttps://hdl.handle.net/20.500.11776/4835
dc.identifier.wosWOS:000767006500001
dc.identifier.wosqualityQ4
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorŞentürk, Mehmet B.
dc.language.isoen
dc.publisherWiley
dc.relation.ispartofJournal Of Obstetrics And Gynaecology Research
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectcervical canal
dc.subjectdiagnostic hysteroscopy
dc.subjecthysteroscopy failure
dc.subjectpain
dc.subjectposition of the cervix
dc.subjectAnesthesia
dc.titleDiagnostic office hysteroscopy; why is it still painful procedure despite the surgical experience and mini-hysteroscope?
dc.typeArticle

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