The scope of Ambulatory Hysteroscopy

The present study measured pain using a visual analog scale (VAS) and analyzed its relationships with variables like menopausal status, parity, uterine and cervical pathology, procedure length, and anxiety in 75 women undergoing ambulatory hysteroscopy (AH).

The patients underwent AH using a vaginoscopic approach and assessment of pain intensity at the end of the procedure.

The study observed-

• 66% of patients undergoing AH reported mild pain, 22% reported moderate pain, and 12% reported severe pain. 
•  Abnormal uterine bleeding (AUB) was the most frequent reason for referral.
• The moderate pain group showed significant association with menopausal status, cervical pathology, and procedure duration, while nulliparity and menopausal status were the significant determining factors.
• The severe pain group showed significant association with cervical pathology, while cervical pathology and uterine pathology were the significant determining factors.

This study proves hysteroscopy is a safe, painless, and gold-standard procedure, and pain experienced during AH is significantly influenced by cervical pathology. 

Henceforth, Gynaecologists should receive training and start using AH to assess the endometrial cavity.

Malu A, Patvekar M, Kolate D. et al. Ambulatory Hysteroscopy: Evaluating Pain and Determining Factors. J ObstetGynecol India. 2023. https://doi.org/10.1007/s13224-023-01811-6