الفهرس 
Randomized control trial comparing patient acceptability and tolerance to pain using oral versus vaginal misoprostol for cervical priming before office hysteroscopy
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Abstract
Objective: To compare between oral and vaginal misoprostol for cervical priming before diagnostic outpatient hysteroscopy (OH) in patient with infertility or abnormal uterine bleeding without the use of anesthesia or analgesia. Design: Randomized controlled trial. Setting: Cairo University teaching hospital. Methods: One hundred patients requiring diagnostic OH for investigation of infertility or abnormal uterine bleeding in the reproductive age. Patients were randomly allocated in a 1:1 ratio to either group A, 200 og misoprostol was taken orally 3h before the procedure and group B, 200 og misoprostol moistened with saline solution was inserted into the posterior vaginal fornix 3 hours before the procedure. A rigid 30 4-mm hysteroscope was used in the vaginoscopic technique. Main outcome measure(s): Pain scoring (visual analog scale) ”VAS”, Ease of cervical entry (VAS), procedural time (minutes) and patient acceptability (VAS). Result (s): Vaginal misoprostol group experienced less pain mean VAS was [3.2±1.2] compared with oral group [6.2±1.5], cervical entry was easier in vaginal group [3.6±1.0 Vs 5.7±1.5], patient acceptability was better [3.0±1.3 Vs 4.7±1.7] and Procedural time for office hysteroscopy was shorter in the vaginal group (2.9±1.1min.) compared with oral group (5.5±1.5 min.). Conclusion (s): The regimen of 200 og vaginal misoprostol administered 3 hours before diagnostic office hysteroscopy in non-pregnant women is a simple, effective, and safe method of cervical priming to facilitate the procedure and decrease pain without anesthesia