Comparison of Sublingual Misoprostol Versus Lidocaine Spray for Hysteroscopy

Outpatient or office hysteroscopy has become the 'gold standard' for the investigation of the intrauterine abnormalities. This minimal invasive modality provides brilliant and clear visualization of the entire uterine cavity and besides this, by the operative channel, minor procedures may easily be performed in the office setting which is priceless for the gynecologist. However, pain related to the procedure may make the procedure uncomfortable for the patient and the physician. Together with the operative time, hysteroscope diameter is considered as the main factor influencing pain. The pain perceived during hysteroscopy may be reduced by using a smaller diameter hysteroscope or by using anesthesia, which decreases pain perception.

In this prospective, randomized, double blind, placebo controlled study, we aim to compare the effectiveness of sublingual misoprostol versus lidocaine pump spray for pain relief during office hysteroscopy.

Inclusion criteria

• Premenopausal women in the proliferative phase of the menstrual cycle with no contraindication for hysteroscopy

Exclusion criteria

• vaginal bleeding at the time of the procedure
• known sensitivity to lidocaine (amide group local anesthetics) or prostaglandins
• epilepsy
• significantly impaired respiratory or cardiac conduction functions
• hypertension
• glaucoma
• renal failure
• acute liver disease
• uncontrolled diabetes mellitus
• pregnancy or suspicion of pregnancy
• pelvic inflammatory disease
• cervical operation history
• vaginismus.