Randomized, controlled, double‐blind trial of topical lidocaine gel and intrauterine lidocaine infusion for pain relief during saline contrast sonohysterography

Yung, S. P.; Lai, Shui Fun; Lam, MF; Lee, Vivian Chi Yan; Li, Raymond; Ho, Pak Chung; Ng, Ernest Hung Yu

doi:10.1002/uog.15775

Cited by 7 publications

(12 citation statements)

References 29 publications

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“…Indication to the diagnostic procedure: six studies focused on infertile women [ 14 , 15 , 16 , 17 , 18 , 19 , 20 ]. The remaining four studies [ 21 , 22 , 23 , 24 ] included women referred to their institutions for different reasons.…”

Section: Resultsmentioning

confidence: 99%

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Evaluating the Effectiveness of Pharmacological Strategies and Further Measures for Pain Relief during Hysterosonosalpingography: A Systematic Review

et al. 2022

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This systematic review aims to evaluate the effectiveness of pharmacological and non-pharmacological strategies for pain relief in women during contrast-enhanced ultrasound for the assessment of tubal patency and uterine disease, compared with placebo or no intervention. In December 2021, we searched the electronic databases (Pubmed, Embase, Sciencedirect, the Cochrane library and Clinicaltrials.gov) without date restriction: We identified 10 randomized control trials (RCTs) (2098 women) eligible for this systematic review, after applying our inclusion and exclusion criteria. Among these, five studies compared the use of painkillers with the placebo, two studies compared different catheter positions in the cervix or in the uterine cavity, and two others considered different temperatures of the contrast medium, as a method to reduce pain. Topical lidocaine applied before the procedure may be associated with effective pain relief during hysterosonography, though the quality of this evidence is low. New echogenic contrast agents and their temperature at 37 °C ensure a less painful procedure. There is insufficient evidence to draw conclusions on the efficacy of other analgesics or strategies.

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Section: Resultsmentioning

confidence: 99%

“…Spieldoch et al [ 18 ] included women with infertility, recurrent miscarriage and abnormal uterine bleeding. In the work of Okzan et al and Yung et al [ 19 , 20 ], the indications to the diagnostic procedure were not specified. Regarding parity, patients were nulliparous in a single study [ 23 ].…”

Section: Resultsmentioning

confidence: 99%

Evaluating the Effectiveness of Pharmacological Strategies and Further Measures for Pain Relief during Hysterosonosalpingography: A Systematic Review

et al. 2022

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“…The patient assumed a lithotomy position and preliminary 2D endovaginal scan using a 7.5-MHz mechanical probe (GE, Voluson, E8) was performed. As a baseline, unenhanced pre-instillation scanning with views of the cervix, uterus, both ovaries, and the cul-de-sac was obtained [7,9,10].…”

Section: Methodsmentioning

confidence: 99%

Diagnostic value of three-dimensional saline infusion sonohysterography in the evaluation of the uterus and uterine cavity lesions

Ahmed

Fadl

Szmigielski

et al. 2018

pjr

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PurposeThe purpose of this review is to illustrate and discuss the seldom used technique of three-dimensional (3D) saline infusion sonohysterography (SIS) based on instillation of sterile saline through a catheter into the uterus under real-time vaginal transducer observation for assessment of the endometrial cavity.Material and methodsThe cases for this pictorial review were selected from the imaging material collected at the Ultrasound Unit, Clinical Imaging Department, Women’s Hospital of Hamad Medical Corporation during a seven-year period from 2011 to 2017. This was a retrospective collection of 216 consecutive cases that underwent two-dimensional (2D) and 3D SIS for evaluation of the uterine cavity, followed by verification of results with histopathology. An open-sided speculum is inserted into the vagina. An intrauterine catheter is then threaded into the endometrial cavity. After that, the speculum is removed carefully, and a vaginal transducer is inserted. Using a 60-ml syringe attached to the catheter, saline solution is instilled under direct real-time observation (2D SIS). Subsequently, reconstruction of the three-dimensional anatomy of the intrauterine cavity is performed.Pictorial reviewThe review presents the most common indication for SIS, like abnormal bleeding in pre- and postmenopausal patients. SIS allows us to distinguish between focal lesions and global endometrial thickening. SIS should be supported as a second-line diagnostic procedure for abnormal uterine bleeding, when findings from transvaginal ultrasound are inconclusive.ConclusionsThe addition of 3D techniques to SIS procedure helps in the distinction between endometrial and myometrial lesions, also it facilitates delineation of uterine anatomy, resulting in more precise and accurate diagnosis.

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“…It has been suggested [33] that SIS performed with an infant feeding tube without a balloon is associated with very low pain levels in comparison to catheters with a balloon (median pain score 10, on a scale of 0-100). That is consistent with the theory that most sensory receptors are located in the area of the cervical internal ostium.…”

Section: Discomfort and Painmentioning

confidence: 99%

“…In a study on 132 patients [40] undergoing GIS with and without lidocaine containing gel prior to a hysteroscopy no differences were seen either. From another randomized double-blind placebo-controlled trial [33] on 120 patients undergoing SIS it could be concluded that topical or local intrauterine application of lidocaine was not effective in reducing pain.…”

Section: Discomfort and Painmentioning

confidence: 99%

Clinical Aspects of HyFoSy as Tubal Patency Test in Subfertility Workup

Exalto

Emanuel

2019

BioMed Research International

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Background. Tubal patency testing is an essential part of female subfertility evaluation. Traditionally, hysterosalpingography (HSG) was the first step to evaluate tubal patency. However, during the past decade Hysterosalpingo-Contrast Sonography (HyCoSy) was introduced in order to avoid radiation exposure and Hysterosalpingo-Foam Sonography (HyFoSy) has been developed as a safe and less painful alternative. Objectives and Rationale. The aim of this narrative review is to provide an overview of the currently available HyFoSy literature and related clinical aspects. Search Methods. A literature search was conducted using PubMed and Embase from the introduction of HyFoSy to March 2019. Unfortunately, a meta-analysis was not possible due to a too small number of studies, being mutually incomparable for the various subjects of clinical aspects, even for the reliability as a test for tubal patency. Outcomes. Nine small studies concluded that the accuracy and effectiveness as a test for tubal patency of 2D- and 3D-HyFoSy are comparable or even better than HSG or HyCoSy. With or without using Doppler techniques, 3D-HyFoSy does not seem to offer benefits above real-time 2D-HyFoSy. Five studies reported on pain and discomfort during HyFoSy, concluding that HyFoSy is a well-tolerated, less painful procedure compared to HSG, without a need for the use of analgesics. There are suggestions about an increased pregnancy rate in the first three cycles after the procedure but in no studies pregnancy outcome after HyFoSy was compared with other or no intervention. Wider Implications. HyFoSy is a promising and safe alternative for HSG with regard to accuracy and effectiveness. HyFoSy lacks radiation and iodine exposure and is a well-tolerated and less painful procedure than HSG, without the need for analgesics. However more research is needed to make clear statements regarding a therapeutic effect of HyFoSy.

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Randomized, controlled, double‐blind trial of topical lidocaine gel and intrauterine lidocaine infusion for pain relief during saline contrast sonohysterography

Abstract: Objectives To evaluate the efficacy of topical lidocaine gel and intrauterine lidocaine infusion administered prior to saline contrast sonohysterography (SCSH)

Cited by 7 publications

References 29 publications

Evaluating the Effectiveness of Pharmacological Strategies and Further Measures for Pain Relief during Hysterosonosalpingography: A Systematic Review

Evaluating the Effectiveness of Pharmacological Strategies and Further Measures for Pain Relief during Hysterosonosalpingography: A Systematic Review

Diagnostic value of three-dimensional saline infusion sonohysterography in the evaluation of the uterus and uterine cavity lesions

Clinical Aspects of HyFoSy as Tubal Patency Test in Subfertility Workup

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