Acceptability and pain of outpatient hysteroscopy

To investigate the pain and acceptability of diagnostic hysteroscopy performed without local anesthesia. Prospective, observational study (Canadian Task Force classification II-2). University-associated department of obstetrics and gynecology. The 1144 consecutive women who underwent diagnostic hysteroscopy. Diagnostic hysteroscopy and endometrial biopsy as indicated. 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). 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.