Akmal El-Mazny1, Nermeen Abou-Salem. 1. Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt. dr_akmalelmazny@yahoo.com
Abstract
OBJECTIVE: To evaluate the efficacy and safety of vaginal misoprostol for cervical priming before diagnostic outpatient hysteroscopy (OH) without anesthesia. DESIGN: Double-blind randomized controlled trial. SETTING:University teaching hospital. PATIENT(S): One hundred fifty patients requiring diagnostic OH for investigation of infertility or abnormal uterine bleeding in the reproductive age. INTERVENTION(S): Patients were randomly allocated into two equal groups (n = 75). In group I, 200 μg misoprostol was inserted into the posterior vaginal fornix 3 hours before OH; in group II (control), vaginal examination was performed without misoprostol administration. A rigid 30° 4-mm hysteroscope was used in the vaginoscopic technique. MAIN OUTCOME MEASURE(S): Ease of cervical entry (Likert scale), procedural time, patient acceptability (Likert scale), and pain scoring (visual analog scale). RESULT(S): Vaginal misoprostol significantly facilitated the procedure; cervical entry was easier, procedural time was shorter, patient acceptability was higher, and pain scoring was lower in group I compared with group II. Side effects of misoprostol were infrequent, minor, and transient. No complications were reported. CONCLUSION(S): The regimen of 200 μg vaginal misoprostol administered 3 hours before diagnostic OH is a simple, effective, and safe method of cervical priming to facilitate the procedure without anesthesia.
RCT Entities:
OBJECTIVE: To evaluate the efficacy and safety of vaginal misoprostol for cervical priming before diagnostic outpatient hysteroscopy (OH) without anesthesia. DESIGN: Double-blind randomized controlled trial. SETTING: University teaching hospital. PATIENT(S): One hundred fifty patients requiring diagnostic OH for investigation of infertility or abnormal uterine bleeding in the reproductive age. INTERVENTION(S): Patients were randomly allocated into two equal groups (n = 75). In group I, 200 μg misoprostol was inserted into the posterior vaginal fornix 3 hours before OH; in group II (control), vaginal examination was performed without misoprostol administration. A rigid 30° 4-mm hysteroscope was used in the vaginoscopic technique. MAIN OUTCOME MEASURE(S): Ease of cervical entry (Likert scale), procedural time, patient acceptability (Likert scale), and pain scoring (visual analog scale). RESULT(S): Vaginal misoprostol significantly facilitated the procedure; cervical entry was easier, procedural time was shorter, patient acceptability was higher, and pain scoring was lower in group I compared with group II. Side effects of misoprostol were infrequent, minor, and transient. No complications were reported. CONCLUSION(S): The regimen of 200 μg vaginal misoprostol administered 3 hours before diagnostic OH is a simple, effective, and safe method of cervical priming to facilitate the procedure without anesthesia.
Authors: Greg J. Marchand; Wesam Kurdi; Katelyn Sainz; Hiba Maarouf; Kelly Ware; Ahmed Taher Masoud; Alexa King; Stacy Ruther; Giovanna Brazil; Kaitlynne Cieminski; Nicolas Calteux; Hollie Ulibarri; Julia Parise; Amanda Arroyo; Diana Chen; Maria Pierson; Rasa Rafie; Mohammad Abrar Shareef Journal: J Turk Ger Gynecol Assoc Date: 2021-12-06