Aim To evaluate the impact of warm distension medium versus room temperature distension medium on pain control among patients undergoing office hysteroscopy. Methods A systematic search was done in PubMed, Cochrane Library, Scopus, and ISI web of science from inception to October 2021. We selected randomized clinical trials (RCTs) compared warmed saline distension medium in the intervention group versus room temperature distension medium in the control group among women undergoing diagnostic and/or operative office hysteroscopy. Revman software was utilized for performing our meta‐analysis. Our primary outcomes were pain scores evaluated by the visual analog scale (VAS) during and after the procedure. Our secondary outcome was the patient satisfaction between both groups. Results Five RCTs met our inclusion criteria with a total number of 441 patients. We found warm saline was linked to a significant reduction in the VAS pain score during the procedure compared to the control group (mean difference [MD] = −1.12, 95% confidence interval [CI] [−1.80, −0.45], p = 0.001). Moreover, the VAS pain score after the procedure was significantly declined among the warm saline group (MD = −0.62, 95% CI [−0.97, −0.27], p = 0.005). Interestingly, more patients were significantly satisfied with warm saline distension medium application compared to room temperature group (odds ratio [OR] = 3.71, 95% CI [2.01, 6.86], p < 0.001). Conclusions Warm saline application in office hysteroscopy is effective in reducing pain during and after the procedure as well as improvement in patient satisfaction.

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Worldwide, breast cancer remains the most frequent malignancy among women [1]. In Egypt, it accounts for 38.8% of female cancers [2,3]. The firstline surgical treatment for breast cancer is modified radical mastectomy (MRM), which involves surgical excision of the whole breast and the axillary lymph nodes [4].Acute postoperative pain is reported in around 40% of breast cancer patients, indicating that postoperative pain treatment is insufficient [5]. In addition, acute postoperative pain could reduce the quality of life by increasing the probability of postmastectomy pain syndrome [6].Another significant issue is the high prevalence of breast cancer-related postoperative nausea and

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