Oral Hyoscine vs Lidocaine-Prilocaine Spray vs Placebo for HSG Pain Relief

June 9, 2026 updated by: Ahmed Samy aly ashour, Cairo University

Oral Hyoscine Butylbromide Versus Topical Lidocaine-Prilocaine Spray Versus Placebo for Pain Relief During Hysterosalpingography: A Randomized, Double-Blind, Double-Dummy, Placebo-Controlled Trial

This single-centre, three-arm, randomised, double-blind, double-dummy, placebo-controlled trial evaluated the efficacy and safety of oral hyoscine butylbromide, topical lidocaine-prilocaine spray and placebo for reducing pain during hysterosalpingography in women with primary infertility. Pain was self-rated using an 11-point numerical rating scale at predefined procedural time points, including cervical instrumentation and uterine filling.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

This was a single-centre, three-arm, randomised, double-blind, double-dummy, placebo-controlled trial conducted at the Department of Obstetrics and Gynaecology, Al Gezeera Hospital, Giza, Egypt. Women aged 18-40 years with primary infertility scheduled for hysterosalpingography during the early proliferative phase of the menstrual cycle were randomly assigned in a 1:1:1 ratio to receive oral hyoscine butylbromide 20 mg with placebo cervical spray, topical lidocaine-prilocaine spray with placebo oral tablet, or double placebo. A double-dummy technique was used to preserve blinding across oral and topical routes of administration. Pain was assessed using a 0-10 numerical rating scale at predefined procedural time points. The primary outcome was pain during cervical instrumentation. Secondary outcomes included pain during uterine filling, pain after speculum insertion, pain 30 minutes after the procedure, patient satisfaction, rescue analgesia and adverse events.Before recruitment and randomisation of the first participant, the protocol was amended and approved by the Research Ethics Committee to specify the topical lidocaine-prilocaine spray formulation and the final outcome hierarchy described below. The registry record was subsequently updated during final study-data updating to reflect the approved amended protocol.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
102

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Locations

  • Egypt
      • Giza, Egypt
        • Algezeera Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Women aged 18 to 40 years
  • Primary infertility
  • Scheduled to undergo hysterosalpingography as part of routine infertility evaluation
  • Regular menstrual cycles
  • Hysterosalpingography scheduled during the early proliferative phase of the menstrual cycle, days 6 to 12
  • Negative urine pregnancy test on the day of the procedure
  • Able to understand and use the 0 to 10 Numerical Rating Scale for Pain assessment

Exclusion Criteria:

  • Secondary infertility
  • Known hypersensitivity to hyoscine, lidocaine, or prilocaine
  • Use of systemic analgesics, sedatives, or antispasmodics within 24 hours before hysterosalpingography
  • Chronic pelvic pain or severe dysmenorrhoea requiring regular analgesia
  • Active pelvic infection
  • Known uterine anomaly
  • Cervical stenosis necessitating anaesthesia
  • History of contrast allergy
  • Inability to cooperate with numerical pain scoring
  • Current pregnancy
  • Severe systemic disease corresponding to American Society of Anesthesiologists physical status class III or higher

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Quadruple

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Oral Hyoscine butylbromide and Placebo Spray
Participants received a single 20 mg oral tablet of hyoscine butylbromide 30 minutes before hysterosalpingography, together with placebo cervical spray applied 10 minutes before the procedure.
Drug: Oral Hyoscine butylbromide and Placebo Spray
Hyoscine butylbromide 20 mg oral tablet, single dose, administered 30 minutes before HSG, plus placebo cervical spray applied to the ectocervix and external cervical os 10 minutes before HSG.
Active Comparator: Topical lidocaine-prilocaine spray and placebo oral tablet
Participants received topical lidocaine-prilocaine spray applied as three sprays to the ectocervix and external cervical os 10 minutes before hysterosalpingography, together with a placebo oral tablet given 30 minutes before the procedure.
Drug: Topical lidocaine-prilocaine spray and placebo oral tablet
Topical lidocaine-prilocaine spray, Manovipercaine Plus, EVA Pharma, Egypt, containing lidocaine 15% and prilocaine 5%, applied as three sprays to the ectocervix and external cervical os 10 minutes before HSG, plus placebo oral tablet administered 30 minutes before HSG.
Placebo Comparator: Double Placebo
Participants received a placebo oral tablet 30 minutes before HSG and placebo cervical spray applied to the ectocervix and external cervical os 10 minutes before the procedure.
Drug: Double Placebo
Placebo oral tablet administered 30 minutes before HSG plus placebo cervical spray applied 10 minutes before HSG, at the same time points as the active interventions.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Pain during cervical instrumentation
Time Frame: Within 1 minute after tenaculum placement and cervical cannulation, before contrast injection.
Pain intensity during cervical instrumentation, including tenaculum placement and cervical cannulation, measured using an 11-point numerical rating scale from 0 to 10, where 0 indicates no pain and 10 indicates the worst pain imaginable
Within 1 minute after tenaculum placement and cervical cannulation, before contrast injection.

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Pain after speculum insertion before cervical instrumentation
Time Frame: Intra-procedure, immediately after speculum insertion and before cervical instrumentation.
Pain intensity will be assessed immediately after speculum insertion and before tenaculum placement or cervical cannulation using the 11-point Numerical Rating Scale for Pain, ranging from 0 to 10, where 0 indicates no pain and 10 indicates the worst imaginable pain. Higher scores indicate worse pain intensity.
Intra-procedure, immediately after speculum insertion and before cervical instrumentation.
Pain 30 minutes after HSG
Time Frame: 30 minutes post-procedure
Pain intensity will be assessed 30 minutes after completion of hysterosalpingography using the 11-point Numerical Rating Scale for Pain, ranging from 0 to 10, where 0 indicates no pain and 10 indicates the worst imaginable pain. Higher scores indicate worse pain intensity.
30 minutes post-procedure
Patient satisfaction 30 minutes after HSG
Time Frame: 30 minutes postprocedure
Patient satisfaction with the procedure, measured using a 0-10 satisfaction scale, where 0 indicates no satisfaction and 10 indicates maximum satisfaction.
30 minutes postprocedure
Pain during uterine filling
Time Frame: During HSG, at the end of uterine filling / immediately after contrast injection.
Pain intensity during or immediately after contrast injection at the end of uterine filling, measured using an 11-point numerical rating scale from 0 to 10, where 0 indicates no pain and 10 indicates the worst pain imaginable.
During HSG, at the end of uterine filling / immediately after contrast injection.
Post-procedure rescue analgesia
Time Frame: After the 30-minute post-procedure pain assessment.
Number and percentage of participants requiring rescue analgesia after completion of the 30-minute post-procedure pain assessment. Rescue analgesia consisted of oral paracetamol 1,000 mg.
After the 30-minute post-procedure pain assessment.
Adverse events related to study medications or hysterosalpingography
Time Frame: Periprocedural: during hysterosalpingography and up to 30 minutes after completion of the procedure.
Adverse events will be reported as the number and percentage of participants experiencing any adverse event potentially related to the study medications or the hysterosalpingography procedure. Events assessed will include dry mouth, nausea, dizziness, blurred vision, tachycardia, vasovagal reaction, allergic symptoms, local irritation or burning, and any other unexpected adverse event.
Periprocedural: during hysterosalpingography and up to 30 minutes after completion of the procedure.
Serious adverse events related to study medications or hysterosalpingography
Time Frame: Periprocedural: during hysterosalpingography and up to 30 minutes after completion of the procedure.
Serious adverse events will be reported as the number and percentage of participants experiencing any serious adverse event during or after hysterosalpingography, including events requiring urgent medical intervention, hospital referral, or prolonged medical observation.
Periprocedural: during hysterosalpingography and up to 30 minutes after completion of the procedure.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Cairo University

Collaborators

Collaborators

An organization other than the sponsor that provides support for a clinical study. This support may include activities related to funding, design, implementation, data analysis, or reporting.
Aljazeera Hospital

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Mahmoud Alalfy, MD, Algezeera Hospital

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
October 3, 2025

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
April 1, 2026

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
April 30, 2026

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
September 21, 2025

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
February 1, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
February 3, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
June 11, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
June 9, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
June 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • HSG-Analgesia-2025

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

Clinical Trials on Hysterosalpingography

Clinical Trials on Oral Hyoscine butylbromide and Placebo Spray

Search Similar Trials

Sponsors and Collaborators

Medical Conditions

Drug Interventions

Conditions

Rare Diseases

Drug Interventions

Dietary Supplements

Sponsor/Collaborators

Locations

Cookie Settings

We use cookies to ensure that we give you the best experience on our website. For more details carefully read our Privacy and Cookies Policy. ...>>>You can change your preferences or withdraw your consent at any time by deleting the cookies from your website or computer as described in the policy. Please accept it and choose your preferences by ticking the corresponding boxes in the "Manage Settings" section below. Please carefully read our Terms of Service before you proceed with using any part of this website.
«Manage Settings