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Fallopian tubal obstruction is associated with increased pain experienced during office hysteroscopy: a retrospective study

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Abstract

This study aimed at evaluating the pain experienced during office hysteroscopy, with selective tubal cannulation and chromopertubation, by women with and without tubal obstruction in order to determine if such condition would be associated with increased pain during the examination. Women with a history of infertility underwent in-office hysteroscopy with selective chromopertubation using a continuous flow office hysteroscope with a 5 Fr operating channel fitted with a 4 Fr catheter for the injection of methylene blue dye. Experienced pain was recorded on a Visual Analog Scale (VAS) during diagnostic hysteroscopy after access to the uterine cavity. Of 90 women, 58 (66.4%) were found with at least one patent fallopian tube and inserted in the group “any”, meanwhile 32 (33.6%) were categorized into group “none” as both tubes were judged obstructed. There was no significant difference between groups in BMI and primary infertility rate, but the difference was significant concerning mean age (32.6 vs. 35.8; p < 0.001). The mean VAS score was 3.34 (± 1.07) in the group “any” and 4.25 (± 1.11) in “none”. Comparing the VAS score of the two groups, the difference was significant (p < 0.001). Tubal occlusion may have a potential role in the pain experienced by women undergoing in-office hysteroscopy. Women with bilateral tubal occlusion experienced a higher level of pain compared with patients with at least one patent fallopian tube. Operators may use milder intrauterine pressure of fluid distension medium when these patients are undergoing in-office hysteroscopy to reduce discomfort.

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Authors and Affiliations

  1. Faculty of Medicine, Institute of Obstetrics and Gynecology, University of Debrecen, Debrecen, Hungary

    Péter Török, Szabolcs Molnár, Singh Jashanjeet & Rudolf Lampé

  2. Center for Assisted Reproduction, University of Debrecen Clinical Center, Debrecen, Hungary

    Tünde Herman

  3. Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy

    Gaetano Riemma

  4. Obstetrics and Gynecology Unit, Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy

    Salvatore Giovanni Vitale

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  1. Péter Török
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  2. Szabolcs Molnár
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Correspondence to Salvatore Giovanni Vitale.

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Török, P., Molnár, S., Herman, T. et al. Fallopian tubal obstruction is associated with increased pain experienced during office hysteroscopy: a retrospective study. Updates Surg 72, 213–218 (2020). https://doi.org/10.1007/s13304-020-00712-x

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