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; Group- A 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 80- 100 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.