Erschienen in:
01.11.2015 | Review
Is pain better tolerated with mini-hysteroscopy than with conventional device? A systematic review and meta-analysis
Hysteroscopy scope size and pain
verfasst von:
Antonio Augusto Santos Paulo, Maria Helena Ruivo Solheiro, Carolina Oliveira Santos Paulo
Erschienen in:
Archives of Gynecology and Obstetrics
|
Ausgabe 5/2015
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Abstract
Background
Hysteroscopy is an indispensable approach in gynecology. Miniaturization may reduce pain allowing office procedures without anesthesia.
Objectives
Our main objective is to
determine if modifications in scope diameters have made office hysteroscopy less painful.
Search strategy
Studies were sought with key words “hysteroscopy” and “pain” from available online sources. Time frame was from 2000 onward. Thirty-three articles were retrieved for detailed analysis.
Selection criteria
Prospective randomized trials, studying pain as main outcome in office hysteroscopy expressed in means, confidence intervals and SD, comparing office mini-hysteroscopy to conventional hysteroscopy. Studies or arms within a study where conscientious sedation, anesthesia or non-steroidal drugs were used were excluded.
Data collection and analysis
We analyzed data from eight studies (seven RCT) comparing mini-hysteroscopy with conventional scopes, involving a total of twenty-three hundred and twenty-two participants, of which nineteen hundred and eighty-six completed the intervention.
Main results
A meta-analysis revealed a significant reduction pain score (MD: −3.64; 95 % CI −5.16 to −2.12; test for overall effect p < 0.00001) and available data support miniaturization decreases pain in outpatient hysteroscopy.
Conclusions
Pain in office hysteroscopy is lower with mini-hysteroscopes.