Feasibility and pain control in outpatient hysteroscopy in postmenopausal women: a randomized trial

Background. Three methods of diagnostic hysteroscopy have been tested for both women's compliance and feasibility of procedures in postmenopause. Methods. Three hundred and sixty-two postmenopausal women were enrolled in a three-arm study: 5 mm diagnostic sheath (Group 1, 119 women), 5 mm sheath with paracervical block (Group 2, 121 women), and 3.5 mm sheath (Group 3, 121 women). CO 2 was the distention medium. Both feasibility of hysteroscopy (procedures failed due to stenosis or incomplete distention of cavity) and discomfort of women have been recorded. Pain perception has been measured on a visual numerical rating scale. Statistical analysis was performed by t -test for unpaired samples and chi-square test. Results. Paracervical block was per se painful in 18.2% and bleeding from injection site occurred in 38.8%. Hysteroscopy failure due to stenosis occurred in 9%, 10% and 0.4% of the three groups respectively ( p <0.01). Intolerable pain was reported by 17% of women in Group 1, 6% in Group 2 ( p <0.0...