Pain and anxiety in office histeroscopy

Rolim, Mayanna Oliveira; Morais, Ana Luiza Ramos; Nogueira, Camila Sampaio; Araujo, Maria do Socorro Monte de; Moraes, Denise Vasconcelos de; Peixoto, Raquel Autran Coelho

doi:10.1590/1806-9282.66.12.1633

Cited by 9 publications

(9 citation statements)

References 20 publications

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“…It is worth mentioning that the degree of pain experienced by the patient is determined by many factors, such as technical aspects, experience of the operator, ab- normalities of the reproductive organs, the total duration of the procedure, and the psychological profile of the patient [10,34,45,46]. A similar relationship was observed in the present study: patients in the RRO group reported more severe pain with the increase in the duration of the procedure.…”

Section: Discussionsupporting

confidence: 83%

Evaluation of Stress Hormone Levels, Preoperative Anxiety, and Information Needs before and after Hysteroscopy under Local Anesthesia in Relation to Transvaginal Procedures under General, Short-Term Anesthesia

Chmaj-Wierzchowska¹,

Wszołek²,

Nowak³

et al. 2022

Clin. Exp. Obstet. Gynecol.

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Background: Hysteroscopy is currently the gold-standard procedure in the evaluation of the uterine cavity and treatment of intrauterine lesions as it is minimally invasive and has high diagnostic efficiency. According to previous observations, many patients are afraid of minimally invasive procedures performed under general anesthesia. They are also afraid of procedures that, according to them, may be associated with pain. To address this issue, in this study, the levels of stress and anxiety, and biochemical parameters indicating the hormonal response in terms of the stress response in hysteroscopic procedures under local anesthesia were compared with those of traditional surgical procedures and uterine cavity curettage procedures under general, short-term anesthesia. Methods: This study included 184 participants: 153 women undergoing diagnostic or operative mini-hysteroscopy procedures with the use of a hysteroscope of a reduced diameter under local, paracervical anesthesia without the participation of an anesthesiologist, and 31 women undergoing hysteroscopy or uterine cavity curettage under general, intravenous, short-term anesthesia with the participation of an anesthesiologist. To determine cortisol and prolactin levels using electrochemiluminescence, blood was collected from the patients on the day of admission to the hospital, i.e., the day of surgery, in the morning, while fasting. An original survey questionnaire, the Amsterdam Preoperative Anxiety and Information Scale (APAIS) and the Visual Analogue Scale (VAS) were used as research tools. The questionnaires were completed by the patients themselves 60 min before the surgery. Results: APAIS: no significant differences in anxiety and information demand scores were observed between the study groups. Anxiety before surgery was significantly higher than that before anesthesia in both groups. Similarly, information demand for surgery was significantly higher than that for anesthesia in both groups. VAS: no significant differences in anxiety and stress scores were observed between the groups. No significant differences in prolactin and cortisol levels were observed between the groups. Conclusions: It can be concluded that it is necessary to apply the interventions that reduce the anxiety of the patients and inform patients about the planned course of the procedure, since higher levels of anxiety before the procedure result in a significant increase in procedure duration, which in turn can increase the pain experienced by the patients.

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Section: Discussionsupporting

confidence: 83%

Evaluation of Stress Hormone Levels, Preoperative Anxiety, and Information Needs before and after Hysteroscopy under Local Anesthesia in Relation to Transvaginal Procedures under General, Short-Term Anesthesia

Chmaj-Wierzchowska¹,

Wszołek²,

Nowak³

et al. 2022

Clin. Exp. Obstet. Gynecol.

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“…23,24 The Pipelle biopsy for endometriosis (PBEM) is inexpensive, less invasive and can be conducted in outdoor settings, and beyond these benefits it also has a risk of failing to obtain adequate sample. 22 Many procedures of sampling cause anxiety and stress among women 25 , but PBEM is being tolerated well by most of the women in comparison to other similar setting techniques. 26 This study is conducted to see the efficacy of PBEM for acquiring adequate sample in outdoor settings for pathology and to report the morphology of sample taken.…”

Section: Introductionmentioning

confidence: 99%

Pipelle Endometrial Sampling and Morphological Findings in Women with Abnormal Uterine Bleeding

Amir¹,

Rehman²

2022

PJMHS

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Background: The abnormal uterine bleeding has many causes and consequences in women. The exact causes are described by histology of sample through D&C. Pipple biopsy samples is considered one of the least invasive, OPD setting technique, comparable to D&C. Objective: To see the adequacy of Pipelle endometrial sampling and morphological findings among women with abnormal uterine bleeding. Study Design: Cross-sectional descriptive study Place and Duration of Study: Department of Gynaecology & Histopathology, Shaikh Zayed Hospital Lahore from 1st May to 31st December 2021. Methodology: Two hundred and thirty seven adult women with AUB recommended for D&C were included. Those with endometrial thickness less than 4mm, having fibroids, with pelvic inflammatory disease, or clotting factor disorders were excluded. Pipelle endometrial sample was taken in Gyne OPD and were examined at Histopathology Department. Results: 80.0% were sampled adequately through Pipelle. Secondary endometrium was most common in 39.9% followed by proliferative endometrium in 36.2% and chronic endometritis 12.2%. There were 6 cases with carcinoma, 4 (2.1%) with adenocarcinoma and 2(1.1%) squamous cell carcinoma. Conclusion: Pipelle Endometrial sampling can be considered an effective methods for endometrial sampling. Keywords: Abnormal uterine bleeding, Pipelle endometrial biopsy, Sample adequacy, Endometrial pathology

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“…Impact of pain on the biopsy’s success remains underestimated and there are only a few reports of inconclusive results [ 14 , 19 , 20 ]. Considering that the relationship between Pipelle sampling and pain in patients undergoing endometrial biopsy for AUB has not been established yet, the aim of this study was to investigate factors influencing it.…”

Section: Introductionmentioning

confidence: 99%

Factors Influencing on Pain in Patients Undergoing Pipelle Endometrial Biopsy for Abnormal Uterine Bleeding: Why a Personalized Approach Should Be Applied?

Terzić

Aimagambetova

Ukybassova

et al. 2022

JPM

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Objectives. Abnormal uterine bleeding (AUB) is a common complaint of women in different age groups, and endometrial biopsy is widely used to investigate the underlying causes. The aim of this observational study was to assess factors influencing pain in patients undergoing endometrial biopsy for AUB. Methods. Pain intensity before, during, and after Pipelle sampling was evaluated using the numerical rating scale (NRS), where “0” represents no pain at all, “10”—the worst pain ever possible. Pain rating was categorized as 1–6—mild to moderate, 7 and above as severe pain. Results. The study included 160 women who underwent Pipelle biopsy. The median age in the cohort was 42 (34–48) years, 18.1% of women were postmenopausal, 56.3% were either overweight or obese, 30% were nulliparous and 80% reported urban residency. The median pain score during the procedure was 2 (0–4). Pain scores of 5 (4–7) were reported with the junior gynecologist and 2 (0–4) in the senior gynecologist (p < 0.0001). Conclusion. The pain was found to have a strong association with the type of provider performing the endometrial sampling procedure. This fact suggests the need for a personalized approach and that psychological or informational interventions should be scheduled before the procedure to decrease pain and increase satisfaction.

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Pain and anxiety in office histeroscopy

Cited by 9 publications

References 20 publications

Evaluation of Stress Hormone Levels, Preoperative Anxiety, and Information Needs before and after Hysteroscopy under Local Anesthesia in Relation to Transvaginal Procedures under General, Short-Term Anesthesia

Evaluation of Stress Hormone Levels, Preoperative Anxiety, and Information Needs before and after Hysteroscopy under Local Anesthesia in Relation to Transvaginal Procedures under General, Short-Term Anesthesia

Pipelle Endometrial Sampling and Morphological Findings in Women with Abnormal Uterine Bleeding

Factors Influencing on Pain in Patients Undergoing Pipelle Endometrial Biopsy for Abnormal Uterine Bleeding: Why a Personalized Approach Should Be Applied?

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