Do Patients With Blocked Tubes Experience More Pain During Outpatient Hysteroscopy Than Those With Patent Tubes ? ! A Prospective Comparative Study

Objective: To study the impact of tubal blockage on pain experienced during and immediately after diagnostic outpatient hysteroscopy. Study design: A prospective comparative study (Canadian Task Force Classification II-2). Setting: Outpatient hysteroscopy clinic at a University Hospital. Patients and Methods: We included 140 women in the childbearing period attending outpatient hysteroscopy clinic for infertility or recurrent miscarriage. Patients were divided into two equal groups; GroupA included those with unilateral or bilateral tubal block (n=70) and Group-B included those with patent tubes on both sides (n =70). All patients had diagnostic outpatient hysteroscopy without the use of anaesthesia or analgesia. Outcomes measured included pain experienced during and immediately after the procedure assessed using a 100 mm -Visual Analogue Scale (VAS) and the successful completion of the procedure. Results: Patients with blocked tubes experienced statistically significant more pain than those with patent tubes both during and immediately after the procedure using a uterine filling pressure of 80 -100 mmHg. However, all procedures were successfully completed with no failures or complications. Conclusion: Blocked Fallopian tubes contribute to pain during and immediately after outpatient hysteroscopy when a uterine filling pressure of 80100 mmHg is used. However, this didn’t adversely affect the success rate of the procedure. For this group of patients, strategies to improve patients’ satisfaction need to be studied with a special attention for; the use of lower uterine filling pressures, shortening the procedure duration and/or the use of preemptive analgesics.