RESUMO
Background: Misoprostol has generally shown good efficacy in promoting cervical softness and facilitating hysteroscopic procedures
Objective: To evaluate the efficacy and safety of vaginal misoprostol for cervical priming before diagnostic outpatient hysteroscopy [OH] without anesthesia
Patients and Methods: Design: Double-blind randomized controlled trial. Setting: University teaching hospital. Patient[s]: Ninety patients requiring diagnostic OH for investigation of infertility or abnormal uterine bleeding in the reproductive age. Intervention[s]: Patients were randomly allocated into two equal groups [n= 45]. In group I, 200 mcg misoprostol was inserted into the posterior vaginal fornix 3 hours before OH; in group II [control], 250 mg metronidazole as placebo was inserted into the posterior vaginal fornix by investigator. A rigid 30 4-mm hysteroscope was used in the vaginoscopic technique. Main Outcome Measure[s]: Ease of cervical entry [Likert scale], procedural time, patient acceptability [Likert scale], and pain scoring [visual analog scale]
Result[s]: Vaginal misoprostol significantly facilitated the procedure; cervical entry was easier, procedural time was shorter, patient acceptability was higher, and pain scoring was lower in group I compared with group II. Side effects of misoprostol were infrequent, minor, and transient. No complications were reported
Conclusion[s]: The regimen of 200 mcg vaginal misoprostol administered 3 hours before diagnostic OH is a simple, effective, and safe method of cervical priming to facilitate the procedure without anesthesia