Could antispasmodic drug reduce pain during hysterosalpingo‐contrast sonography (HyCoSy) in infertile patients? A randomized double‐blind clinical trial

Moro, Francesca; Selvaggi, Luigi; Sagnella, Francesca; Morciano, Andrea; Martínez, Domingo; Gangalè, Maria Francesca; Ciardulli, Andrea; Palla, Carola; Uras, M. L.; Feo, Emma De; Boccia, Stefania; Tropea, Anna; Lanzone, Antonio; Apa, Rosanna

doi:10.1002/uog.11089

Cited by 27 publications

(26 citation statements)

References 40 publications

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“…Jareethum et al 45 compared two different analgesic drugs, hyoscine‐N‐butylbromide and mefenamic, versus placebo for pain relief during SHG in a double‐blind RCT. No statistically significant differences were found in pain reduction between the three groups, similar to the results of Moro et al 44.…”

Section: Do Pain Medications Reduce Pain?supporting

confidence: 90%

“…Although it has been found that women better tolerate SHG and HyCoSy compared to HSG41, 42, 43, should we expect painkillers to significantly reduce pain during SHG and HyCoSy or will there be no effect, as with HSG? In a large double‐blind RCT in this issue of the Journal, Moro et al 44 demonstrated no significant pain reduction with an antispasmodic drug compared with placebo in patients undergoing HyCoSy with 30 mL 1 : 1 saline and air. In this study, 816 patients undergoing HyCoSy were randomized to receive 10 mg hyoscine‐N‐butylbromide or placebo.…”

Section: Do Pain Medications Reduce Pain?mentioning

confidence: 99%

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Fear no pain: uterine cavity and tubal patency assessment tests should be pain free

Tur-Kaspa

2012

Ultrasound in Obstet & Gyne

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Section: Do Pain Medications Reduce Pain?supporting

confidence: 90%

Section: Do Pain Medications Reduce Pain?mentioning

confidence: 99%

Fear no pain: uterine cavity and tubal patency assessment tests should be pain free

Tur-Kaspa

2012

Ultrasound in Obstet & Gyne

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“…Inflation of the catheter's balloon induced the nerve fibers of the uterine cervix, leading to pelvic pain and vasovagal response. In addition, local prostaglandins release (due to of the uterine expansion) caused uterine cramps and pain [25]. In our study, we found that inflating the balloon inside the uterine cavity was more painful and could result in a larger number of vasovagal reactions.…”

Section: Discussionmentioning

confidence: 61%

Pain and side effects associated with 4-dimensional hysterosalpingo-contrast sonography for evaluating of the fallopian tubes patency

Zhang

et al. 2017

Computer Assisted Surgery

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4-Dimensional hysterosalpingo-contrast sonography (4 D HyCoSy) using SonoVue is regarded as a really good option available for evaluating fallopian tubal patency. This study was designed to assess the pain and adverse effects incurred by women undergoing 4 D HyCoSy. Through evaluating the pelvic pain immediately after 4 D HyCoSy and 30 min after 4 D HyCoSy, the circumstances of the pain relief was also observed. The predictive factors of pain were assessed simultaneously. 827 consecutive women as part of infertility evaluation were included. The pain experienced was then assessed on a 10-cm visual analogue scale (VAS). Each patient was questioned to rate the pain at two different points of time (T1, immediately after 4 D HyCoSy; T2, 30 min after 4 D HyCoSy). 818/827 (98.9%) patients completed the procedure. Pain was experienced by 757/818 (92.5%) of subjects. 30 min after HyCoSy procedure, only 0.5% (4/818) patients feel severe pelvic pain and after 15-30 minutes of rest, these patients were relieved of pain. Age, cycle length, duration of menses, and duration of infertility were not significantly correlated with pain associated with 4 D HyCoSy as assessed by VAS. Women with tubal obstruction experienced a significant increase in 4 D HyCoSy-associated pain. There were significant differences in the degree of pain between different tubal patency (p <0.01). Overall, 4 D HyCoSy, a userfriendly, multidimensional technology, has the advantage of real-time, dynamic, well tolerated, and low serious complications, which make it a good way for evaluating fallopian tubal patency. The technique aids in making choices concerning further procedures for the diagnosis and treatment of infertility. Most of women experience pain associated with the procedure and 30 minute period of observation is useful.

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“…Although convincing, this hypothesis has been disconfirmed by a recent study. In fact it was demonstrated that a preventive administration of antispasmodic drug such as hyoscine-N-butylbromide, a muscarinic receptor antagonist with anticholinergic effects, does not decrease pain during HyCoSy by affecting uterine contractions [23]. …”

Section: Discussionmentioning

confidence: 99%

Hysterosalpingocontrast sonography (HyCoSy): evaluation of the pain perception, side effects and complications

Marci

Marcucci

et al. 2013

BMC Med Imaging

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BackgroundTubal and uterine cavity diseases commonly compromise female fertility. At the present time, hysteroscopy, laparoscopy with chromopertubation and RX-Hysterosalpingography (RX-HSG) are widely accepted screening procedures enabling the effective assessment of both tubal patency and uterine cavity. Nevertheless, consistent evidence supports the reliability of Hysterosalpingocontrast sonography (HyCoSy) in uterine cavity and tubal patency investigation, as a part of the standard infertility work-up. This prospective study was aimed at evaluating the tolerability of the technique as well as the incidence of related side effects and complications in a large series of infertile patients.MethodsPain perception of 632 infertile women was measured by means of an 11-point numeric rating scale. Side effects and late complications were also recorded.ResultsThe mean numeric rating scale was 2.15 ± 2.0 SD. Most of the patients (374/632, 59.17%) rated HyCoSy as a non-painful procedure, whereas 24.36% (154/632) women reported mild pelvic pain and 9.96% (63/632) classified the discomfort as “moderate”. Only 6.48% (41/632) of the patient population experienced severe pelvic pain. Fifteen (2.37%) patients required drug administration for pain relief. Twenty-six patients (4.11%) showed mild vaso-vagal reactions that resolved without atropine administration. No severe vaso-vagal reactions or late complications were observed.ConclusionsHyCoSy is a well-tolerated examination and the associated vagal effects are unusual and generally mild. Consequently, we support its introduction as a first-line procedure for tubal patency and uterine cavity investigation in infertile women.

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Could antispasmodic drug reduce pain during hysterosalpingo‐contrast sonography (HyCoSy) in infertile patients? A randomized double‐blind clinical trial

Abstract: Objective To assess the effectiveness of an antispasmodic drug, hyoscine-N-butylbromide, in reducing pain during hysterosalpingo-contrast sonography (HyCoSy). Methods

Cited by 27 publications

References 40 publications

Fear no pain: uterine cavity and tubal patency assessment tests should be pain free

Fear no pain: uterine cavity and tubal patency assessment tests should be pain free

Pain and side effects associated with 4-dimensional hysterosalpingo-contrast sonography for evaluating of the fallopian tubes patency

Hysterosalpingocontrast sonography (HyCoSy): evaluation of the pain perception, side effects and complications

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