Office Hysteroscopy in Postmenopausal Women: A Randomized Trial of Cervical Preparation Strategies
A Four-Arm Prospective Randomized Controlled Trial Comparing Oral Misoprostol, Two Vaginal Estrogen Regimens, and No Cervical Preparation Before Office Hysteroscopy in Postmenopausal Women
The goal of this randomized controlled trial is to evaluate the effectiveness of different cervical preparation strategies before office hysteroscopy in postmenopausal women undergoing evaluation for intrauterine pathology.
The main questions to answer are:
Does cervical preparation improve the success rate of complete office hysteroscopy in postmenopausal women? Which cervical preparation strategy provides better patient tolerance, as assessed by pain intensity during the procedure?
Researchers will compare four cervical preparation protocols (14-day vaginal estrogen, 7-day vaginal estrogen, oral misoprostol, and no cervical preparation) to determine their effects on procedural success, pain, procedure duration, and perioperative complications.
Participants will be randomly assigned to one of the four cervical preparation protocols. They will undergo office hysteroscopy using a vaginoscopic ("no touch") approach without anesthesia. Then, they will have pain assessed using a visual analog scale (VAS) during the procedure. Finally, these informations will be collected: procedural success, procedure duration, bleeding, and perioperative complications.
調査の概要
状態
研究の種類
入学 (推定)
段階
- 適用できない
連絡先と場所
研究連絡先
- 名前:Mohammed Amine Hannachi, Assistant professor
- 電話番号:+21699696332
- メール:medaminehannachi3@gmail.com
研究場所
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Tunis Governorate
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Tunis、Tunis Governorate、チュニジア、1007
- 募集
- Maternity and neonatology center of Tunis
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コンタクト:
- Khaled Neji, Professor
- 電話番号:+21651352742
- メール:DRKHALEDNEJI21@GMAIL.COM
-
コンタクト:
- Mohammed Amine Hannachi
- 電話番号:99696332
- メール:medaminehannachi3@gmail.com
-
-
参加基準
適格基準
就学可能な年齢
- 子
- 大人
- 高齢者
健康ボランティアの受け入れ
説明
Inclusion Criteria:
- Women with postmenopausal status.
- Scheduled for office hysteroscopy for the evaluation of suspected intrauterine pathology.
- Able to understand the study procedures and provide written informed consent.
Exclusion Criteria:
- Known or suspected hormone-dependent malignancy (e.g., breast or endometrial cancer).
- Active genital tract infection.
- Contraindication or known hypersensitivity to misoprostol or vaginal estrogen.
- Refusal to undergo office hysteroscopy without anesthesia.
- Active uterine bleeding preventing adequate hysteroscopic visualization on the day of the procedure.
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
|
他の:No Cervical Preparation
Participants undergo office hysteroscopy without any cervical preparation.
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No pharmacological cervical preparation is administered before office hysteroscopy.
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実験的:Oral Misoprostol
Participants receive 200 µg of misoprostol administered sublingually 2 hours before office hysteroscopy.
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Misoprostol 200 µg administered sublingually 2 hours before office hysteroscopy for cervical ripening.
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実験的:7-Day Vaginal Estrogen
Participants receive 20 µg vaginal estrogen once daily for 7 consecutive days before office hysteroscopy.
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Vaginal estrogen 20 µg administered once daily for 7 consecutive days before office hysteroscopy to facilitate cervical ripening.
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実験的:14-Day Vaginal Estrogen
Participants receive 20 µg vaginal estrogen once daily for 14 consecutive days before office hysteroscopy.
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Vaginal estrogen 20 µg administered once daily for 14 consecutive days before office hysteroscopy to facilitate cervical ripening.
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Successful office hysteroscopy
時間枠:During the office hysteroscopy procedure
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A complete hysteroscopic examination of the uterine cavity.
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During the office hysteroscopy procedure
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Pain during office hysteroscopy
時間枠:During the office hysteroscopy procedure. 5 minutes after the procedure. 10 minutes after the procedure.
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Patient-reported pain assessed using a 10-cm Visual Analog Scale (VAS) during hysteroscopy, 5 minutes after the procedure and 10 minutes after the procedure.
0 is assigned to no pain & 10 is assigned to the most pain imaginable.
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During the office hysteroscopy procedure. 5 minutes after the procedure. 10 minutes after the procedure.
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Procedure-related complications
時間枠:During the procedure and up to 24 hours after office hysteroscopy
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Incidence of complications occurring during or immediately after office hysteroscopy, including cervical laceration, uterine perforation, excessive bleeding, vasovagal reaction, or failure requiring conversion to hysteroscopy under anesthesia.
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During the procedure and up to 24 hours after office hysteroscopy
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Patient satisfaction with cervical preparation
時間枠:Immediately after the procedure
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Patient satisfaction with the assigned cervical preparation protocol, assessed using a Patient Satisfaction Percentage Scale, a self-reported scale ranging from 0% to 100%, where 0% indicates not satisfied at all and 100% indicates completely satisfied.
Higher scores indicate greater patient satisfaction.
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Immediately after the procedure
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Adverse effects of cervical preparation
時間枠:From date of randomization up to 14 days
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Incidence of adverse effects related to cervical preparation, including abdominal pain, uterine cramping, vaginal bleeding, nausea, vomiting, diarrhea, headache, dizziness, or local vaginal irritation.
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From date of randomization up to 14 days
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協力者と研究者
捜査官
- スタディチェア:KHALED M NEJI、Maternity and neonatology center of Tunis
出版物と役立つリンク
一般刊行物
- Wood MA, Kerrigan KL, Burns MK, Glenn TL, Ludwin A, Christianson MS, Bhagavath B, Lindheim SR. Overcoming the Challenging Cervix: Identification and Techniques to Access the Uterine Cavity. Obstet Gynecol Surv. 2018 Nov;73(11):641-649. doi: 10.1097/OGX.0000000000000614.
- Samy A, Nabil H, Abdelhakim AM, Mahy ME, Abdel-Latif AA, Metwally AA. Pain management during diagnostic office hysteroscopy in postmenopausal women: a randomized study. Climacteric. 2020 Aug;23(4):397-403. doi: 10.1080/13697137.2020.1742685. Epub 2020 Apr 17.
- Sauvan M, Pourcelot AG, Fournet S, Fernandez H, Capmas P. Office hysteroscopy for postmenopausal women: Feasibility and correlation with transvaginal ultrasound. J Gynecol Obstet Hum Reprod. 2018 Dec;47(10):505-510. doi: 10.1016/j.jogoh.2018.08.018. Epub 2018 Sep 5.
- Sorbi F, Fambrini M, Saso S, Lucenteforte E, Lisi F, Piciocchi L, Cioni R, Petraglia F. Office hysteroscopy in pre- and post-menopausal women: a predictive model. Gynecol Endocrinol. 2021 Mar;37(3):206-210. doi: 10.1080/09513590.2020.1864316. Epub 2020 Dec 26.
- Giorda G, Scarabelli C, Franceschi S, Campagnutta E. Feasibility and pain control in outpatient hysteroscopy in postmenopausal women: a randomized trial. Acta Obstet Gynecol Scand. 2000 Jul;79(7):593-7.
- Gorodeski GI. Effects of menopause and estrogen on cervical epithelial permeability. J Clin Endocrinol Metab. 2000 Jul;85(7):2584-95. doi: 10.1210/jcem.85.7.6671.
- Cooper NA, Smith P, Khan KS, Clark TJ. Does cervical preparation before outpatient hysteroscopy reduce women's pain experience? A systematic review. BJOG. 2011 Oct;118(11):1292-301. doi: 10.1111/j.1471-0528.2011.03046.x. Epub 2011 Jul 29.
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研究開始 (実際)
一次修了 (実際)
研究の完了 (推定)
試験登録日
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QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
キーワード
追加の関連 MeSH 用語
その他の研究ID番号
- CERV-PREP-MENO-HSC
個々の参加者データ (IPD) の計画
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