Factors influencing the severity of pain during hysterosalpingography.

Objective: To analyze factors influencing the severity of pain during hysterosalpingography (HSG).

Methods: A prospective randomized study was performed among women with ongoing infertility undergoing HSG at a center in Poland between March and September 2013. The patients were assigned by random draw to receive 0.1g ketoprofen or 2.5g metamizole intravenously. Patients and physicians performing HSG were masked to assignment, but the healthcare workers who administered analgesics were not. Pain was assessed by a visual analogue scale (VAS) during and after the HSG procedure.

Results: A total of 80 women were assigned to ketoprofen and 89 were assigned to metamizole. There were no significant differences in VAS scores with regard to the administered analgesic, patient age, duration of infertility, medical history (previous delivery, abdominal surgery), or type of infertility. However, women who went on to have abnormal HSG results had higher VAS scores at time of contrast instillation and 30minutes after the procedure than did those who had confirmed bilateral patency of the tubes (P≤0.03 for both).

Conclusion: An abnormal HSG result seems to be the main factor influencing the sensation of pain perceived by patients during the procedure.