- ICH GCP
- Amerikanska kliniska prövningsregistret
- Klinisk prövning NCT07697781
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.
Studieöversikt
Status
Betingelser
Studietyp
Inskrivning (Beräknad)
Fas
- Inte tillämpbar
Kontakter och platser
Studiekontakt
- Namn: Mohammed Amine Hannachi, Assistant professor
- Telefonnummer: +21699696332
- E-post: medaminehannachi3@gmail.com
Studieorter
-
-
Tunis Governorate
-
Tunis, Tunis Governorate, Tunisien, 1007
- Rekrytering
- Maternity and neonatology center of Tunis
-
Kontakt:
- Khaled Neji, Professor
- Telefonnummer: +21651352742
- E-post: DRKHALEDNEJI21@GMAIL.COM
-
Kontakt:
- Mohammed Amine Hannachi
- Telefonnummer: 99696332
- E-post: medaminehannachi3@gmail.com
-
-
Deltagandekriterier
Urvalskriterier
Åldrar som är berättigade till studier
- Barn
- Vuxen
- Äldre vuxen
Tar emot friska volontärer
Beskrivning
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.
Studieplan
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Behandling
- Tilldelning: Randomiserad
- Interventionsmodell: Parallellt uppdrag
- Maskning: Ingen (Open Label)
Vapen och interventioner
Deltagargrupp / Arm |
Intervention / Behandling |
|---|---|
|
Övrig: No Cervical Preparation
Participants undergo office hysteroscopy without any cervical preparation.
|
No pharmacological cervical preparation is administered before office hysteroscopy.
|
|
Experimentell: Oral Misoprostol
Participants receive 200 µg of misoprostol administered sublingually 2 hours before office hysteroscopy.
|
Misoprostol 200 µg administered sublingually 2 hours before office hysteroscopy for cervical ripening.
|
|
Experimentell: 7-Day Vaginal Estrogen
Participants receive 20 µg vaginal estrogen once daily for 7 consecutive days before office hysteroscopy.
|
Vaginal estrogen 20 µg administered once daily for 7 consecutive days before office hysteroscopy to facilitate cervical ripening.
|
|
Experimentell: 14-Day Vaginal Estrogen
Participants receive 20 µg vaginal estrogen once daily for 14 consecutive days before office hysteroscopy.
|
Vaginal estrogen 20 µg administered once daily for 14 consecutive days before office hysteroscopy to facilitate cervical ripening.
|
Vad mäter studien?
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Successful office hysteroscopy
Tidsram: During the office hysteroscopy procedure
|
A complete hysteroscopic examination of the uterine cavity.
|
During the office hysteroscopy procedure
|
|
Pain during office hysteroscopy
Tidsram: During the office hysteroscopy procedure. 5 minutes after the procedure. 10 minutes after the procedure.
|
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.
|
During the office hysteroscopy procedure. 5 minutes after the procedure. 10 minutes after the procedure.
|
Sekundära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Procedure-related complications
Tidsram: During the procedure and up to 24 hours after office hysteroscopy
|
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.
|
During the procedure and up to 24 hours after office hysteroscopy
|
|
Patient satisfaction with cervical preparation
Tidsram: Immediately after the procedure
|
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.
|
Immediately after the procedure
|
|
Adverse effects of cervical preparation
Tidsram: From date of randomization up to 14 days
|
Incidence of adverse effects related to cervical preparation, including abdominal pain, uterine cramping, vaginal bleeding, nausea, vomiting, diarrhea, headache, dizziness, or local vaginal irritation.
|
From date of randomization up to 14 days
|
Samarbetspartners och utredare
Sponsor
Utredare
- Studiestol: KHALED M NEJI, Maternity and neonatology center of Tunis
Publikationer och användbara länkar
Allmänna publikationer
- 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.
Studieavstämningsdatum
Studera stora datum
Studiestart (Faktisk)
Primärt slutförande (Faktisk)
Avslutad studie (Beräknad)
Studieregistreringsdatum
Först inskickad
Först inskickad som uppfyllde QC-kriterierna
Första postat (Faktisk)
Uppdateringar av studier
Senaste uppdatering publicerad (Faktisk)
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senast verifierad
Mer information
Termer relaterade till denna studie
Nyckelord
Ytterligare relevanta MeSH-villkor
- Urogenitala sjukdomar
- Genitala sjukdomar
- Patologiska processer
- Kvinnliga urogenitala sjukdomar
- Kvinnliga urogenitala sjukdomar och graviditetskomplikationer
- Livmodersjukdomar
- Genitala sjukdomar, kvinnor
- Blödning
- Livmoderblödning
- Patologiska tillstånd, tecken och symtom
- Metroragi
- Sjukvårdskvalitet, tillgång och utvärdering
- Terapeutik
- Fettsyror
- Lipider
- Biologiska faktorer
- Hälsovårdsutvärderingsmekanismer
- Hälsovårdskvalitet
- Prostaglandiner, syntetiska
- Prostaglandiner
- Eikosanoider
- Fettsyror, omättade
- Autaikoider
- Inflammationsmedlare
- Epidemiologiska studieegenskaper
- Prostaglandiner E, syntetiska
- Misoprostol
- Kliniska protokoll
Andra studie-ID-nummer
- CERV-PREP-MENO-HSC
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