Acceptability and pain of outpatient hysteroscopy

J Am Assoc Gynecol Laparosc. 2000 Feb;7(1):71-5. doi: 10.1016/s1074-3804(00)80012-2.


Study objective: To investigate the pain and acceptability of diagnostic hysteroscopy performed without local anesthesia.

Design: Prospective, observational study (Canadian Task Force classification II-2).

Setting: University-associated department of obstetrics and gynecology.

Patients: The 1144 consecutive women who underwent diagnostic hysteroscopy.

Interventions: Diagnostic hysteroscopy and endometrial biopsy as indicated.

Measurements and main results: Patients were asked to rate the pain experienced on a 10-cm visual analog scale and to state if they were willing to repeat the procedure. The mean pain score was 4.7 +/- 2.5; 398 patients (34.8%) experienced severe pain. No risk factors for painful hysteroscopy were found, although abnormality of the cervical canal was associated with high pain scores. Acceptance of the procedure was high, 83.0% (950 women).

Conclusion: Diagnostic hysteroscopy is a painful procedure even when performed with atraumatic technique by experienced surgeons. Most women, however, stated they were willing to have a second procedure under the same conditions.

MeSH terms

  • Ambulatory Care*
  • Anesthesia, Local
  • Female
  • Humans
  • Hysteroscopy* / adverse effects
  • Middle Aged
  • Pain Measurement
  • Pain* / etiology
  • Patient Acceptance of Health Care*
  • Prospective Studies
  • Uterine Diseases / diagnosis