Influencing factors of moderate-to-severe pain in real-time three-dimensional hysterosalpingo-contrast sonography / 第二军医大学学报

ABSTRACT

ObjectiveTo explore the influencing factors of moderate-to-severe pain in transvaginal real-time threedimensional hysterosalpingo-contrast sonography (RT-3D-HyCoSy). MethodsTotally 235 suspected infertility patients who underwent RT-3D-HyCoSy in the First Affiliated Hospital of Anhui University of Chinese Medicine between Jan. 2017 and Dec. 2018 were chosen for this study. The degree of pain was assessed by numeric rating scale (NRS). The patients were divided into non-moderate-to-severe pain group (NRS score was 0-3) and moderate-to-severe pain group (NRS score was 4-10). Patients' age, infertile time, infertile type, fallopian tube patency, balloon size (≥2 mL), contrast agent reflux, uterine space-occupying lesion, uterine malformation, intrauterine adhesion, uterine position, ectopic pregnancy history, gynecological inflammation, pelvic surgery history and emotion were collected for comparison between the two groups. Multivariate logistic regression model was used to analyze the risk factors of moderate-to-severe pain during RT-3D-HyCoSy examination, and receiver operating characteristic (ROC) curve was drawn to evaluate the predictive value of each factor. ResultsThe univariate analysis showed that the balloon size (≥2 mL), contrast agent reflux, abnormal fallopian tube patency, intrauterine adhesion, and emotional tension were the influencing factors for moderate-to-severe pain (P<0.01, P< 0.05). The multivariate logistic regression model showed that balloon size (≥2 mL), abnormal fallopian tube patency, and emotional tension were the risk factors for moderate-to-severe pain (odds ratio [OR]?2.223, 95% CI 1.088-4.542, P<0.05; OR?13.824, 95% CI 5.582-34.239, P<0.01 OR?2.606, 95% CI 1.255-5.414, P<0.05). ROC curve confirmed that multi-factor (balloon size ≥2 mL, abnormal fallopian tube patency, and emotional tension) combined had the highest prediction accuracy for moderate-to-severe pain (area under curve [AUC]?0.841, 95% CI 0.785-0.898). ConclusionBalloon size (≥2 mL), abnormal fallopian tubal patency and emotional tension are risk factors for moderate-to-severe pain in RT-3D-HyCoSy examination. During RT-3D-HyCoSy examination, we should pay attention to the causes of moderate-tosevere pain and avoid them, so as to improve the comfort level of patients and the success rate of the examination.