A randomised comparison of vaginoscopic office hysteroscopy and saline infusion sonography: a patient compliance study.

Objective: The purpose of this study was to compare patient discomfort during saline infusion sonography (SIS) and office hysteroscopy performed according to a vaginoscopic approach.

Design: Randomised controlled trial.

Setting: University hospital.

Population: Women with an indication for further investigation of the uterine cavity.

Methods: A total of 100 women randomly allocated to either SIS or vaginoscopic office hysteroscopy in an outpatient clinic.

Main Outcome Measures: Scores on a visual analogue scale (VAS) for pain and a present pain intensity (PPI) scale, conclusiveness and success rate.

Results: The patients' pain scores on both the VAS and the PPI were lower for SIS when compared with office hysteroscopy (P < 0.05). However, in cases of severe pain (VAS > 7 or PPI > 2), there was no statistically significant difference between both groups. The success rate, defined as adequate inspection of the cervical canal and uterine cavity, was 94% for SIS compared with 92% for office hysteroscopy (P = 0.633). SIS, multiparity, shorter procedure time and position of the uterus in anteversion decreased pain scores among women studied.

Conclusions: Both SIS and office hysteroscopy are successful procedures and well tolerated by women. SIS induces significantly less discomfort than office hysteroscopy and should therefore be considered the method of choice.