The study is conducted to assess whether ultrasound guidance can facilitate the access of the office hysteroscope into the uterine cavity of patients with previous failure of office hysteroscopy due to cervical stenosis.
Patients with history of failure of office hysteroscopy
Pelvic inflammatory disease
Severe vaginal bleeding
Pregnancy
Allergy to lidocaine, prilocaine or diclofenac potassium
Parallel
Ultrasound guided office hysteroscopy group
Procedure/SurgeryOne hour before office hysteroscopy, 100 mg of diclofenac potassium will be administered per orem. The patients will be asked to drink about one liter of water and to avoid urination before the procedure Moreover, a few minutes prior to the office hysteroscopy, 3 ml of 5% lidocaine and prilocaine topical cream will be introduced into the endocervical canal. All procedures will be performed using the vaginoscopic technique. A rigid 2.9-mm hysteroscope with a 30° lens and a 5-mm outer sheath (Karl Storz GmbH, Tuttlingen, Germany) will be used in all procedures. A 5 Fr grasper and 5 Fr scissors will be used to widen the stenotic internal or external ostia. Transabdominal ultrasound will be used to guide the access of the hysteroscope to the uterine cavity
Conventional office hysteroscopy group
Procedure/SurgeryOne hour before office hysteroscopy, 100 mg of diclofenac potassium will be administered per orem . The patients will be asked to drink about one liter of water and to avoid urination before the procedure Moreover, a few minutes prior to the office hysteroscopy, 3 ml of 5% lidocaine and prilocaine topical cream will be introduced into the endocervical canal. All the procedures will be performed using the vaginoscopic technique. A rigid 2.9-mm hysteroscope with a 30° lens and a 5-mm outer sheath (Karl Storz GmbH, Tuttlingen, Germany) will be used in all procedures. A 5 Fr grasper and 5 Fr scissors will be used to widen the stenotic internal or external ostia.
Success of office hysteroscopy [ ability to gain access of the hysteroscope into uterine cavity]
Percentage of successfully performed office hysteroscopy \[ = number of successful office hysteroscopies /total number of office hysteroscopies\]
Intensity of pain
Measured using 100 mm visual analogue scale ( 0 = no pain and 100 = worst possible pain)
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Cairo University
Lead sponsor
Bedaya Hospital
Collaborator
