Cervical priming with hydroscopic dilatator before hysteroscopy: Effect on pain scores and ease of the procedure

Abstract

OBJECTIVE: Aquacryl hydrogel is one of the cervical dilatators which is a synthetic rigid hydroscopicgel rod, indicated to be used for cervical preparation. The authors aimed to determine whether preoperativecervical preparation with Aquacryl hydrogel before hysteroscopy has any favorable effects eitherfor the patient (pain scores) or for the surgeon (ease of the procedure).STUDY DESIGN: The randomized controlled trial was undertaken in the Obstetrics and GynecologyDepartment of a University Hospital setting. Forty-three reproductive age women scheduled for hysteroscopydue to gynecological indications were randomized to receive hydroscopic dilatators for cervicalpreparation (n=19) or no intervention before the procedure (n=27). Visual analog scale (VAS) wasused to evaluate pain scores until the operation. Analgesic administration was done in case of a VASscore ?40 or patients’ demand for analgesia.Intraoperatively, mean arterial pressure and pulse weredocumented in order to evaluate analgesic requirement.RESULTS: Median VAS scores at hydroscopic dilatator administration 0th, 1st, 2nd, 3rd, and 4th hours afterinsertion were 29±24 (0-80), 14±15 (0-6), 13±15 (0-5), 8±9 (0-30) and 5±9 (0-3), respectively; wherepain scores significantly decreased in time (p<0.05). There was no significant difference between meanarterial pressure and heart rate values between groups throughout the preoperative and intraoperativefollow up (p>0.05).CONCLUSIONS: This study revealed that, Aquacryl hydrogel for cervical priming before office hysteroscopyis not effective to reduce the pain of patients’ during the procedure but also does not ease accessto the uterine cavity. Therefore, it is not advantageous for the patient to use this agent before hysteroscopy.