Comparison Between the Intrauterine Lidocaine and Warm Saline Distention Medium for Pain Relief During Office Hysteroscopy

Procedure: The procedure was done in the lithotomy position during the postmenstrual period. We used a 30° angle 2.9 mm rigid hysteroscopy with 3.8 mm diagnostic sheath \[TEKNO®, LIGHT XA 180, Germany\]. Vaginoscopic approach was used for insertion of the hysteroscopy in all cases (no use of speculum or tenaculum). The hysteroscopy was gently introduced into the uterine cavity after visualization of the cervix and identification of the external os. We used saline as the distension medium and the maximum pressure was set at 70 to 80 mm Hg by an automated hysteroscopic pump system (Hysteromat II, Karl Storz), which automatically measured intrauterine fluid pressure. In lidocaine group: we added 5 ml of lidocaine 2% to 500 ml of saline solution that was used as a distention medium. The uterine cavity and tubal ostia were systematically visualized. All procedures were done by an operator using the same equipment.