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Vaginoscopy Compared to Traditional Hysteroscopy for Hysteroscopy Morcellation in Outpatient Clinic. A Randomized Trial

Not Applicable
Active, not recruiting
Conditions
Leiomyoma of Uterus
Interventions
Procedure: standard hysteroscopy
Procedure: vaginoscopy
Registration Number
NCT04373694
Lead Sponsor
Centre hospitalier de l'Université de Montréal (CHUM)
Brief Summary

This study is a randomized controlled trial take place in a fertility outpatient clinic in an academic hospital. Women between 18 and 52 years old requiring polypectomy or myomectomy by hysteroscopy morcellation for abnormal uterine bleeding or for fertility issue are included. The aim is to evaluate pain perception between vaginal and traditional hysteroscopy for hysteroscopic morcellation. The investigator's hypothesis is that pain perception is lower using vaginoscopy compared to traditional hysteroscopy.

Detailed Description

78 participants will be randomised in two groups:

1. traditional hysteroscopy: under intravenous sedation, hysteroscopic morcellation is perform after speculum insertion, vaginal cleansing, and paracervical anesthesia with xylocain 1%.

2. Vaginal hysteroscopy: under intravenous sedation, hysteroscopic morcellation is perform after vaginal cleansing using vaginal distension with saline solution

In addition to pain perception, other outcomes includes: complication rates, time to continue fertility treatment, time to pregnancy

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
Female
Target Recruitment
78
Inclusion Criteria
  • polyp or fibroid previously diagnosed by hysteroscopy
  • polyp less than 2 cm
  • submucosal fibroid (type 0 or 1 according to the 2011 FIGO uterine fibroid classification) less than 2 cm
  • if more than 1 fibroid: total fibroid have to be less or equal 4 cm
Exclusion Criteria
  • cervical stenosis
  • polyp or fibroid more than 2 cm
  • pregnancy
  • blood dyscrasia

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Standard hysteroscopystandard hysteroscopymorcellation hysteroscopy with intravenous sedation and paracervical bloc
Vaginoscopyvaginoscopymorcellation hysteroscopy with only intravenous sedation
Primary Outcome Measures
NameTimeMethod
Difference in pain perception between vaginoscopy group and traditional hysteroscopy groupimmediately after intervention

10 point visual analog pain scale: 0 for no pain to 10 for unbearable pain

Secondary Outcome Measures
NameTimeMethod
Difference in length of time of procedure between vaginoscopy group and traditional hysteroscopy groupimmediately after intervention

length of time in minutes between start and end of procedure including morcellation

Difference in proportion of uterine perforation between vaginoscopy group and traditional hysteroscopy groupimmediatly after surgery

presence of one or more signs during intervention: extension of the instrument goes beyong the limitation of the uterus, loss of resistance, sudden loss of vision, direct visualisation of the perforation

Difference in length of time to continue fertility treatment between vaginoscopy group and traditional hysteroscopy groupup to 1 year

length of time in months to continue fertility treatment after procedure

Difference in proportion of vasovagal syncope between vaginoscopy group and traditional hysteroscopy groupimmediately after surgery

Presence of jerky abnormal movements or a slow weak pulse rate associated to at least one symptoms: nausea, pale skin, blurred vision, warm feeling or cold sweat.

Difference in length of time to pregnancy between vaginoscopy group and traditional hysteroscopy groupup to 1 year

length of time in months to be pregnant after procedure

Trial Locations

Locations (1)

CHUM - Clinique Médecine et biologie de la reproduction

🇨🇦

Montreal, Quebec, Canada

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