Search Results (4)

Modern, small-diameter endoscopic instruments, such as resectoscopes (e.g., the GUBBINI System) and mini-hysteroscopes, are widely used in clinical practice. These tools allow endoscopic procedures to be conducted without cervical dilation, often in an outpatient setting, and under local anesthesia alone. Background/Objectives: The present retrospective study aimed to analyze the perioperative and delayed complications of hysteroscopy performed under local anesthesia. This study also assessed the pain experienced during hysteroscopy under local anesthesia, depending on the type of procedure performed. Methods: A retrospective analysis was conducted in 1945 patients who underwent hysteroscopy under local anesthesia at the Center for Hysteroscopy, Heliodor Święcicki Gynecological and Obstetrical Clinical Hospital, Karol Marcinkowski Medical University, Poznań, Poland, between January 2021 and December 2023. Hysteroscopic procedures were performed with the GUBBINI Mini Hystero-Resectoscope through a paracervical block using lignocaine. Results: The procedure was discontinued in 46 patients, accounting for 2.36% of all hysteroscopies. The most common reasons for procedure discontinuation were severe pain and uterine perforation, accounting for 52.8% and 13% of discontinued procedures, respectively. The complication rates were low: uterine perforation occurred in 0.3% of cases (n = 6), and late complications requiring readmission occurred in 0.2% (n = 3). The average pain intensity score for all the patients was 2 points (2.8 ± 2.14). Conclusions: Our study confirmed that hysteroscopy performed under local anesthesia is a safe and effective diagnostic and therapeutic method for selected uterine pathologies, noting increased risks in cases such as extensive intrauterine adhesions. The low complication rates in both the perioperative and postoperative stages indicate the high safety profile of this procedure, particularly when performed by experienced personnel using standardized, validated protocols. Full article

Background/Objectives: The purpose of this study is to evaluate the role of disease acceptance and stress intensity in explaining anxiety levels and the need for information among patients undergoing a minihysteroscopy procedure under local anesthesia, in the period preceding operative hysteroscopy. Methods: The study included 116 patients who were admitted to the Center for Hysteroscopy under Local Anesthesia at the Heliodor Święcicki Gynecological and Obstetrical Clinical Hospital of Karol Marcinkowski Medical University in Poznań, Poland, from December 2024 to January 2025, for operative hysteroscopy using the GUBBINI Mini Hystero-Resectoscope under local anesthesia (paracervical block with lignocaine). Results: A low level of preoperative anxiety (χ² = 19.9; p < 0.001) and a moderate need for information about the procedure (χ² = 31.8; p < 0.001) were statistically significant among the majority of patients (n = 82; 71% vs. n = 67; 58%) in the study group before undergoing minihysteroscopy under local anesthesia. Conclusions: Stress and anxiety are inherent aspects of surgical intervention and hospitalization. Therefore, it is reasonable to develop preoperative support standards to help reduce stress levels, which, in turn, can lead to better adaptation to surgical intervention. Full article

Introduction: Hysteroscopy is a key gynecological procedure for diagnosing and treating endometrial conditions. While hysteroscopy is often performed in office settings without sedation, patients frequently report significant pain during the procedure. This study aims to evaluate the efficacy of paracervical anesthesia with mepivacaine compared to placebo in managing pain during office hysteroscopy. Methods: This randomized, single-center, double-blind, placebo-controlled trial was conducted at Puerta de Hierro University Hospital (Madrid, Spain) from June 2021 to June 2022. A total of 108 women were randomized to receive either mepivacaine 2% or a saline placebo prior to hysteroscopy. Pain was assessed using a visual analog scale (VAS) at various stages of the procedure. Results: The results showed no significant differences in pain levels between the mepivacaine and placebo groups during the procedure. Both groups exhibited similar rates of complications and procedural difficulties. Factors influencing perceived pain included a history of vaginal delivery and the type of instruments used, but anesthesia did not demonstrate a significant impact on pain reduction in any subgroup. Discussion: Our findings indicate that paracervical anesthesia with mepivacaine does not significantly reduce pain during office hysteroscopy, consistent with previous studies. The variability in pain experiences suggests that individual factors, such as pain thresholds and anxiety, may play a significant role. A more personalized approach to pain management, combining pharmacological and non-pharmacological strategies, may be necessary to enhance patient comfort. Future research should involve larger multicenter trials to further explore these findings. Full article

Pain accompanying medical procedures can be considered in the “mind-body” problem of accounting for and describing the relationship between mental and physical processes (psyche and soma). Background/Objectives: The purpose of this study is to evaluate the severity of pain among patients undergoing a minihysteroscopy procedure under local anesthesia using the “GUBBINI SYSTEM” (GUBBINI Mini Hystero-Resectoscope; Tontarra Medizintechnik, Tuttlingen, Germany) and to assess the association of various covariates with pain during the procedure, including patient emotional state. Methods: This study included 171 patients admitted to the Center for Hysteroscopy under Local Anesthesia at the Heliodor Święcicki Gynecological and Obstetrical Clinical Hospital of the Karol Marcinkowski Medical University in Poznań, Poland, for hysteroscopic treatment under local anesthesia (paracervical, using lignocaine). The Center for Hysteroscopy is the first certified “CENTER OF EXCELLENCE” of The International Society for Gynecologic Endoscopy (ISGE) in Poland. Results: A positive relationship was observed between alexithymia and its trait of difficulty identifying emotions and pain, as well as between perceived pain and one of the deficits of emotional processing—signs of unprocessed emotion. Conclusions: In conclusion, before the hysteroscopy, adequate information and counseling related to the procedure can effectively reduce the pain and anxiety levels of the women, and nurses can navigate this stressful process. Providing education and counseling to all women undergoing hysteroscopy, and explaining the procedure in detail, should be the preferred approach. Full article