الفهرس 
HYSTEROSCOPYOnly 14 pages are availabe for public view
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Abstract
Background: Outpatient hysteroscopy is adiagnostic procedure. It indicated mainly in evaluation of women with abnormal uterine bleeding. The uterine cavity is a potential space so we need to use adistension media to see it.
Aim of the Work: to assess the efficacy of warm saline dissension media in decreasing the pain in women undergoing diagnostic hysteroscopy
Patients and Methods: This study is a randomized controlled clinical trial the study will include 82 women planned for diagnostic outpatient office bysterocopy in Early cancer detection unit in Ain Shams Matemity Hospital from November 2021.
Results: No statistically significant differences were found between both groups in any of the studied confounding Variables, including age, BMI, parity, history of previous verine surgeries, hysteroscopic findings or duration of procedure. Immediately after the examination, mean (SD; 95% confidence interval) pain intensity in the warmed saline solution group was 3.84 (2.71; 2.89-4.79), and in the room- temperature saline solution group was 4.31 (3.02; 3.18-5.44) (p=0.51). At 1 and 15 minutes after the procedure, pain intensity in the 2 groups was, respectively, 2.41 (2.00; 1.66- 3.16) and 2.43 (2.49; 1.57-3.30) (p = 0.96), and 1.83 (2.30; 1.02-2.64) and 1.85 (2.06; 1.08-2.62) (p-0.96). Differences were not significant. Overall, VAS scores were statistically significantly lower over time in the warm distention medium group compared to the room-temperature medium group. Also, patient satisfaction, indicated by the proportion of the patients who would undergo the hysteroscopic examination again using the same method, was statistically significantly higher in the warm distention medium group compared to the room-temperature medium group (89.74% vs 71.05% respectively). Patients reported a greater feeling of comfort with the saline solution warmed to 37.5°C, but this was not proved through the variables evaluated. Although there was less feeling of discomfort when the temperature of the saline solution in contact with the vagina was closer to body temperature, this did not influence the final outcome of the study, that is, degree of pain during and after the examination.
Conclusion: Pain is measured by VAS score is significantly lower at the end of the procedure in warm saline distension medium group compared to room temperature distension medium group (1.64±0.82vs. 3.05±1.17) respectively. The same finding also after 15 minutes of the end of the procedure (0.35±0.57 vs 1.05±0.81) respectively in warm saline distension medium group and room temperature saline distension medium group. Patient satisfaction, indicated by the proportion of the patients who undergo hysteroscopic examination again using the same method, was significantly higher in warm saline distension medium group. The result was (89.74% vs 71.05%) respectively in warm saline distension medium group and room temperature saline distension medium group. Time taken to complete the procedure in minutes is not significantly different and the result was (2.0-8.0 vs 1.6- 9.0 minutes) respectively in warm saline distension medium group and room temperature saline distension medium group.