Avaliação da dor na histeroscopia diagnóstica por vaginoscopia utilizando-se, como meio de distensão, solução salina à temperatura corporal. Ensaio clínico randomizado

Abstract

PURPOSE: to compare diagnostic hysteroscopy through vaginoscopy, using warm saline solution, with traditional technique, regarding to pain, patient satisfaction and feasibility of the procedure. METHODS: randomized clinical trial, involving 184 women, referred for diagnostic hysteroscopy, between May and December of 2006. Participants were randomized to be submitted to hysteroscopy by the proposed technique, which consisted of access through vaginoscopy using normal saline at 36°C as distension medium, no speculum or cervical grasping, or by the traditional technique with CO2. In both techniques, a 2.7 mm hysteroscope was used. Pain was assessed by the analogical visual scale, during the procedure and every five minutes after it. RESULTS: the mean pain score was 1.60 in the proposed technique and 3.39 in the traditional technique (p<0.01). Lower pain scores were also observed after 5, 10 and 15 minutes (p<0,01) as well as after 20 minutes (p=0.056). In the proposed technique, 82.4% of the procedures were feasible, while, in the traditional technique, 84.9% were so (p=0.64). Satisfaction with the procedure was referred by 88.7% of women submitted to the proposed technique and by 76.3% of women submitted to the traditional technique (p<0.05). CONCLUSIONS: diagnostic hysteroscopy by the proposed technique resulted in less pain, same feasibility and greater satisfaction of patients.