Randomised trial on pain reduction in hysterosalpingography - a modified technique without vulsellum forceps

Authors

  • Olubukola AT Omidiji, F.M.C.R., M.P.H. Radiation Biology, Radiotherapy, Radiodiagnosis and Radiography, University of Lagos/ Lagos University Teaching Hospital, Idi-Araba,Lagos, Nigeria.
  • Omodele A Olowoyeye, F.M.C.R. Ph.D. Department of Radiation Biology, Radiotherapy and Radiodiagnosis, College of Medicine University of Lagos, Idi-araba, Lagos, Nigeria.
  • Richard Efidi, F.M.C.R Radiodiagnosis Department, Crestview Radiology ,Lagos,Nigeria.
  • Omololu Adegbola, F.M.C.O.G Obstetrics and Gynaecology, College of Medicine, University of Lagos/ Lagos University Teaching Hospital, Idi-Araba,Lagos,Nigeria.
  • Oluyemisi O.Toyobo, F.M.C.R Department of Radiodiagnosis, Crestview Radiology, Lagos, Nigeria.
  • Ogonna Okeke, M.B.B.S Department of Radiodiagnosis, Lagos University Teaching Hospital, Idi-araba, Lagos, Nigeria.
  • Thaddeus N Opara, F.M.C.R. Department of Radiology, Federal Medical Centre, Ebute Metta, Lagos
  • Abidemi Shabi, M.B.B.S Department of Radiology, Federal Medical Centre, Ebute Metta, Lagos, Nigeria.

DOI:

https://doi.org/10.46475/aseanjr.v23i3.187

Keywords:

HSG, Technique, Pain, Cervical grasp, Vulsellum, Procedure duration

Abstract

ABSTRACT

Background: Pain is the most common side effect of hysterosalpingography (HSG) and partly arises from vulsellum placement on the cervix and cervical traction.

Objective: To study the effect of conducting HSG without grasping the cervix with vulsellum forceps on the time taken to complete the procedure, pain experienced by the participants and diagnostic quality of HSG images produced.
Materials and Methods: A randomized controlled trial of 64 consenting adult women referred to the Radiodiagnostic department for HSG from July to December 2020 was carried out. The women were consecutively selected and randomly distributed into two groups: Group 1 - no cervical grasp and Group 2 – with cervical grasp with vulsellum forceps. HSG was done using a fluoroscopy machine, following the standard hospital protocol with speculum, Leech Wilkinson cannula and Urografin 76%. Procedure time, procedure pain using the visual analog scale and diagnostic quality of images were assessed. Data analysis was done using Microsoft Excel and SPSS software version 22.
Results: The overall mean duration of the procedure was 12.59 minutes. There was no significant difference in the procedure duration between both groups.  The overall mean pain scores immediately and 15 minutes after the procedure were 4.83 and 2.23 respectively. Significant differences in pain scores were seen in the immediate post procedure 3.94 (group 1) versus 5.72 (group 2) and 15 minutes post procedure 1.75 (group 1) versus 2.72 (group 2). After adjusting for confounders, the pain score was noted to be significantly related to the HSG technique with vulsellum use associated with the higher immediate post HSG pain score. No significant difference was seen in the diagnostic image quality between group I and II
Conclusion: The elimination of vulsellum forceps during hysterosalpingography was associated with reduced pain in the immediate and 15 minutes after the procedure, without significantly increasing the procedure duration. It had no deleterious effect on the image quality.

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Author Biographies

Olubukola AT Omidiji, F.M.C.R., M.P.H., Radiation Biology, Radiotherapy, Radiodiagnosis and Radiography, University of Lagos/ Lagos University Teaching Hospital, Idi-Araba,Lagos, Nigeria.

Department of Radiation Biology, Radiotherapy and Radiodiagnosis, Senior Lecturer/Consultant

Omodele A Olowoyeye, F.M.C.R. Ph.D., Department of Radiation Biology, Radiotherapy and Radiodiagnosis, College of Medicine University of Lagos, Idi-araba, Lagos, Nigeria.

Department of Radiation Biology, Radiotherapy and Radiodiagnosis, Associate Professor

Richard Efidi, F.M.C.R, Radiodiagnosis Department, Crestview Radiology ,Lagos,Nigeria.

Radiodiagnosis Department, Consultant

 

Omololu Adegbola, F.M.C.O.G, Obstetrics and Gynaecology, College of Medicine, University of Lagos/ Lagos University Teaching Hospital, Idi-Araba,Lagos,Nigeria.

Department of Obstetrics and Gynaecology, Professor

Oluyemisi O.Toyobo, F.M.C.R, Department of Radiodiagnosis, Crestview Radiology, Lagos, Nigeria.

Department of Radiodiagnosis, Senior Consultant

Ogonna Okeke, M.B.B.S, Department of Radiodiagnosis, Lagos University Teaching Hospital, Idi-araba, Lagos, Nigeria.

Department of Radiodiagnosis, Senior Resident

Thaddeus N Opara, F.M.C.R., Department of Radiology, Federal Medical Centre, Ebute Metta, Lagos

Department of Radiology, Federal Medical Centre, Ebute Metta, Lagos, Nigeria.

Abidemi Shabi, M.B.B.S, Department of Radiology, Federal Medical Centre, Ebute Metta, Lagos, Nigeria.

Department of Radiology, Junior resident

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Published

2022-12-31

How to Cite

1.
Omidiji O, Olowoyeye O, Efidi R, Adegbola O, Toyobo O, Okeke O, Opara T, Shabi A. Randomised trial on pain reduction in hysterosalpingography - a modified technique without vulsellum forceps. ASEAN J Radiol [Internet]. 2022Dec.31 [cited 2023Feb.9];23(3):161-83. Available from: https://asean-journal-radiology.org/index.php/ajr/article/view/187

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