Warm Versus Room Temperature Saline as a Uterine Distension Medium for Pain Reduction in Women Undergoing Outpatient Hysteroscopy: Protocol for a Randomized Controlled Trial
15 augustus 2026 bijgewerkt door: Reem Mohamed
The goal of this randomized clinical trial is to determine whether using warmed saline at 37°C during outpatient diagnostic hysteroscopy can reduce pain compared with room-temperature saline.
The study will include women aged 18 to 70 years who are undergoing outpatient diagnostic hysteroscopy.
Participants will be randomly assigned to receive either warmed saline at 37°C or room-temperature saline as the fluid used to expand the uterine cavity during the procedure.
Data collected will then be used to compare pain scores between the two groups during hysteroscopy and one hour after the procedure.
The study will also assess whether participants require additional pain medication and whether the procedure is stopped because of severe pain.
The main hypothesis is that warmed saline at 37°C will result in lower pain scores than room-temperature saline.
Studie Overzicht
Toestand
Nog niet aan het werven
Interventie / Behandeling
Gedetailleerde beschrijving
Outpatient diagnostic hysteroscopy is commonly performed for the evaluation of intrauterine abnormalities and other gynecological indications. Pain during hysteroscopy may be influenced by cervical manipulation, uterine distension, and uterine contractions. The temperature of the distension medium may influence patient discomfort during the procedure.
This study is a parallel-group superiority randomized controlled trial designed to compare warmed normal saline at 37°C with room-temperature normal saline as the uterine distension medium during outpatient diagnostic hysteroscopy.
Eligible participants will be women aged 18 to 70 years who are scheduled for outpatient diagnostic hysteroscopy and who are able to understand and report pain using a visual analog scale. Participants will provide written informed consent before enrollment.
A total of 60 participants will be randomized in a 1:1 ratio to one of two study groups. The intervention group will undergo hysteroscopy using normal saline warmed to 37°C. The comparison group will undergo hysteroscopy using normal saline at room temperature. The temperature of the saline will be monitored using an infrared thermometer.
Pain intensity during the hysteroscopy will be assessed using a 0-to-10 visual analog scale and will constitute the primary outcome of the study. Secondary outcomes will include pain intensity one hour after the procedure, the need for additional analgesia during or after the procedure, and the proportion of participants in whom the procedure is abandoned because of intolerable pain.
The study will be conducted in the outpatient Endoscopy Unit of Demerdash Maternity Hospital, Ain Shams University. Diagnostic hysteroscopy will be performed using a 5-mm Karl Storz hysteroscope by the same senior physician.
The study is designed to determine whether the use of warmed saline at 37°C provides a clinically meaningful reduction in pain compared with room-temperature saline during outpatient diagnostic hysteroscopy.
Studietype
Ingrijpend
Inschrijving (Geschat)
60
Fase
- Niet toepasbaar
Contacten en locaties
In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.
Studiecontact
- Naam: Reem M Sadiq, MBBCh
- Telefoonnummer: +201113939778
- E-mail: reem_mohamed@med.asu.edu.eg
Studie Locaties
-
-
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Cairo, Egypte
- Ain Shams University Maternity Hospital
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Contact:
- Reem M Sadiq, MBBCh
- Telefoonnummer: +201113939778
- E-mail: reem_mohamed@med.asu.edu.eg
-
-
Deelname Criteria
Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Ja
Beschrijving
Inclusion Criteria:
- Age 18-70 years.
- Ability to understand and report pain using the Visual Analog Scale.
- Willingness to undergo outpatient hysteroscopy and provide written informed consent.
Exclusion Criteria:
- Congenital genital tract malformations: including these patients could introduce a confounding factor because pain may result from difficult anatomy rather than the temperature of the distension medium.
- Previous hysteroscopic procedures: pain perception may be influenced by prior experience rather than the intervention itself
- Suspected pregnancy: standard gynecologic practice considers pregnancy a contraindication to elective diagnostic hysteroscopy
- Active pelvic infection: instrumentation of an infected genital tract may increase morbidity and facilitate ascending infection. Also, pain scores may reflect infection-related pain rather than procedural pain.
Studie plan
Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Ander
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Verdrievoudigen
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
|
Experimenteel: Warmed saline at 37 degrees celsius
Participants randomized to this arm will undergo outpatient diagnostic hysteroscopy using normal saline warmed to 37°C as the uterine distension medium.
The planned allocation is 30 participants.
|
Normal saline warmed to 37°C and used as the uterine distension medium during outpatient diagnostic hysteroscopy.
The temperature of the saline will be monitored using an infrared thermometer before and during the procedure.
|
|
Actieve vergelijker: Room-Temperature Saline
Participants randomized to this arm will undergo outpatient diagnostic hysteroscopy using normal saline at room temperature as the uterine distension medium.
The planned allocation is 30 participants.
|
Normal saline at room temperature used as the uterine distension medium during outpatient diagnostic hysteroscopy.
|
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Pain intensity during outpatient diagnostic hysteroscopy measured using the Visual Analog Scale (VAS)
Tijdsspanne: During the hysteroscopy procedure
|
Pain intensity will be assessed using a Visual Analog Scale (VAS) ranging from 0 to 10, where 0 represents no pain and 10 represents the worst pain imaginable.
The VAS score recorded immediately after the hysteroscopy will be compared between participants receiving warmed normal saline at 37°C and those receiving room-temperature normal saline.
|
During the hysteroscopy procedure
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Pain intensity one hour after outpatient diagnostic hysteroscopy measured using the Visual Analog Scale (VAS)
Tijdsspanne: 1 hour after completion of the hysteroscopy
|
Pain intensity will be assessed one hour after completion of the hysteroscopy using a Visual Analog Scale (VAS) ranging from 0 to 10, where 0 represents no pain and 10 represents the worst pain imaginable.
VAS pain scores will be compared between participants receiving warmed normal saline at 37°C and those receiving room-temperature normal saline.
|
1 hour after completion of the hysteroscopy
|
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Need for additional analgesia after outpatient diagnostic hysteroscopy
Tijdsspanne: 1 hour after completion of the procedure
|
The need for additional analgesia will be recorded as a binary outcome according to whether the participant requires analgesic medication.
The proportion of participants requiring additional analgesia will be compared between the warmed saline at 37°C group and the room-temperature saline group.
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1 hour after completion of the procedure
|
|
Proportion of procedures abandoned due to intolerable pain
Tijdsspanne: During the hysteroscopy procedure
|
The proportion of participants in whom outpatient diagnostic hysteroscopy is abandoned because of intolerable pain will be recorded and compared between the warmed saline at 37°C group and the room-temperature saline group.
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During the hysteroscopy procedure
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Medewerkers en onderzoekers
Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.
Sponsor
Publicaties en nuttige links
De persoon die verantwoordelijk is voor het invoeren van informatie over het onderzoek stelt deze publicaties vrijwillig ter beschikking. Dit kan gaan over alles wat met het onderzoek te maken heeft.
Algemene publicaties
- Tawfek ME, Hemeda HM, Ibrahim MA. Effectiveness of warm saline distension media on relieving pain in outpatient office hysteroscopy: a randomized controlled clinical trial. Journal of Gynecology & Reproductive Medicine. 2019;3(1):1-7.
- De Silva PM, Smith PP, Cooper NAM, Clark TJ; Royal College of Obstetricians and Gynaecologists. Outpatient Hysteroscopy: (Green-top Guideline no. 59). BJOG. 2024 Dec;131(13):e86-e110. doi: 10.1111/1471-0528.17907. Epub 2024 Aug 19.
- Kapur S, Gruber A, Sekar H, Mafuta J, Lodhi W, Sivashanmugarajan V, Yoong W. Does temperature of distending medium matter in outpatient hysteroscopy? A double-blinded cohort control observational study of room temperature versus warmed saline. J Obstet Gynaecol Res. 2020 Mar;46(3):485-489. doi: 10.1111/jog.14207. Epub 2020 Jan 28.
- Issat T, Beta J, Nowicka MA, Durczynski A, Jakimiuk AJ. Pain assessment during outpatient hysteroscopy using room temperature versus warm normal saline solution as a distention medium - a prospective randomized study. Clin Exp Obstet Gynecol. 2017;44(3):359-363.
- Evangelista A, Oliveira MA, Crispi CP, Lamblet MF, Raymundo TS, Santos LC. Diagnostic hysteroscopy using liquid distention medium: comparison of pain with warmed saline solution vs room-temperature saline solution. J Minim Invasive Gynecol. 2011 Jan-Feb;18(1):104-7. doi: 10.1016/j.jmig.2010.09.009.
- Nair VG, Mahajan R, Aziz A, Tiwari S. Effectiveness of warm saline for pain relief in office hysteroscopy: a prospective randomized control trial. International Journal of Clinical Obstetrics and Gynaecology. 2020;4(4):85-88. DOI: 10.33545/gynae.2020.v4.i4b.628.
- Baradwan S, Khalil M, Alshahrani MS, Albouq B, AlSghan R, Khadawardi K, Mohamed DF, Yousef DH, Kamal SHM, Abdel Halim HW, Elhawary MAA, Alkholy EA, Elsharkawy MRM, Abdelhakim AM, Abbas AM, Dahshan SA, Alshawadfy A, Soror GI. Warm saline effectiveness for pain relief in office hysteroscopy: A systematic review and meta-analysis of randomized controlled trials. J Obstet Gynaecol Res. 2022 Jul;48(7):1523-1530. doi: 10.1111/jog.15272. Epub 2022 Apr 24.
- Abdallah KS, Gadalla MA, Breijer M, Mol BWJ. Uterine distension media for outpatient hysteroscopy. Cochrane Database Syst Rev. 2021 Nov 26;11(11):CD006604. doi: 10.1002/14651858.CD006604.pub2.
Studie record data
Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.
Bestudeer belangrijke data
Studie start (Geschat)
1 september 2026
Primaire voltooiing (Geschat)
1 december 2026
Studie voltooiing (Geschat)
1 december 2026
Studieregistratiedata
Eerst ingediend
15 augustus 2026
Eerst ingediend dat voldeed aan de QC-criteria
15 augustus 2026
Eerst geplaatst (Werkelijk)
19 augustus 2026
Updates van studierecords
Laatste update geplaatst (Werkelijk)
19 augustus 2026
Laatste update ingediend die voldeed aan QC-criteria
15 augustus 2026
Laatst geverifieerd
1 augustus 2026
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Andere studie-ID-nummers
- FMASU MS 555/ 2026
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