Trendelenburg Lithotomy Position During Vaginoscopic Office Hysteroscopy Reduces Pain and Procedure Duration
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Abstract
Objective: Vaginoscopic office hysteroscopy (VOH) is a gold standard diagnostic method for many uterine disorders. However, it may result in patient discomfort. This study aimed to investigate the effect of the Trendelenburg lithotomy (TL) position, in respect of the level of pain and procedure time during the VOH for diagnostic purposes. Methods: This study included 157 patients between the ages of 20 and 65 years, of whom 74 underwent diagnostic VOH with the lithotomy position (group 1) and 83 with the TL position (group 2). Subsequent evaluation that was conducted on both groups included visual analog scale scores of patients, procedure duration, and the attitudinal Likert-type survey of doctors. Results: A significant difference was found between groups 1 and 2 in pain scores (p<0.001), procedure duration (p<0.001), and attitudinal Likert-type survey of doctors (p=0.002). Group 2 reported lower pain scores than group 1 (3.34 +/- 2.37 and 5.69 +/- 2.33, respectively). Similarly, the procedure duration in group 2 was significantly reduced (60.11 +/- 26.3 and 83.3 +/- 29.5, respectively). The attitudinal Likert-type survey of doctors also showed significant improvement in group 2 (3.48 +/- 0.97 vs. 3.03 +/- 0.86, respectively). Conclusion: VOH with the TL position lowered the pain scores in patients and reduced the procedure duration. The TL position is a good way of increasing the patients' compliance and tolerance. Likewise, it makes the procedure easier for the doctor without any additional price.