Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Apr;303(4):999-1007.
doi: 10.1007/s00404-020-05885-9. Epub 2020 Nov 19.

Impact of anxiety levels on the perception of pain in patients undergoing office hysteroscopy

Felice Sorrentino  1 , Annamaria Petito  2 , Stefano Angioni  3 , Francesco D'Antonio  4 , Melania Severo  2 , Maria Cristina Solazzo  4 , Raffaele Tinelli  5 , Luigi Nappi  4
Affiliations

Impact of anxiety levels on the perception of pain in patients undergoing office hysteroscopy

Felice Sorrentino et al. Arch Gynecol Obstet. 2021 Apr.

Abstract

Objective: This study aimed at assessing the impact of anxiety on pain perception during hysteroscopy and to highlight the possible contribution of factors related to pain perception.

Materials and methods: 104 women with indication for office hysteroscopy fullfilled anonymous self-report questionnaires during the waiting time, before the procedure. The first self-report questionnaire included general patient information and an overall assessment of the degree of satisfaction with the information received before the procedure. The level of pre-procedural anxiety was measured through the State-Trait Anxiety Inventory STAI-Y1 (state anxiety). The perceived stress was assessed using the Perceived Stress Scale (PSS). The intensity of pain during the procedure and 20 min later was assessed with VAS score.

Results: The average waiting time was of 192.33 ± 91 min. 59 patients (56.7%) performed the examination without analgesia while 45 women (43.3%) required analgesia. 28 women (27%) experienced mild pain, 34 (33%) moderate pain and 42 (40%) severe pain. The patients who performed the procedure without analgosedation had an average STAI-Y1 score of 44.81 ± 1.20, compared to women who required analgosedation (average score of 49.40 ± 1.64). The perceived level of stress was also associated with the use of analgosedation. Patients who did not request any anesthetic intervention obtained a PSS average score of 16.66 ± 0.75, compared to the subgroup with anesthesia (score of 19.76 ± 0.90).

Conclusions: Anxiety represents a key element for the success of ambulatory hysteroscopy. The management of anxiety can reduce the request for analgesia with a consequent optimization of time, costs and safety.

Keywords: Anxiety; Hysteroscopy; Pain; Stress; VAS.

PubMed Disclaimer

Conflict of interest statement

We declare that we have no conflict of interest.

Figures

Fig. 1
Fig. 1
VAS score
Fig. 2
Fig. 2
Quality of information received by patients
Fig. 3
Fig. 3
Pearson correlation coefficient between STAY-Y1 e VAS
Fig. 4
Fig. 4
Pearson correlation coefficient between STAI-Y and information received
Fig. 5
Fig. 5
T test: analysis of the difference between averages of scores obtained at STAI-Y1 (patients with and without analgosedation)
Fig. 6
Fig. 6
T test: analysis of the difference between averages of PSS scores (patients with and without analgosedation)
Fig. 7
Fig. 7
T test: comparative analysis between waiting time for patients with and without analgosedation
Fig. 8
Fig. 8
T test: analysis between the STAI Y-2 average scores between menopausal and non-menopausal patients
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Bettocchi S, Nappi L, Ceci O, Selvaggi L. What does ‘‘diagnostic hysteroscopy’’ mean today? The role of the new techniques. Curr Opin Obstet Gynecol. 2003;15:303–308. - PubMed
    1. Bettocchi S, Nappi L, Ceci O, Selvaggi L. Office hysteroscopy. Obstet Gynecol Clin N Am. 2004;31:641–654. doi: 10.1016/j.ogc.2004.05.007. - DOI - PubMed
    1. Bettocchi S, Ceci O, Nappi L, Di Venere R, Masciopinto V, Pansini V, Pinto L, Santoro A, Cormio G. Operative office hysteroscopy without anesthesia: analysis of 4863 cases performed with mechanical instruments. J Am Assoc Gynecol Laparosc. 2004;11:59–61. doi: 10.1016/S1074-3804(05)60012-6. - DOI - PubMed
    1. Bettocchi S, Ceci O, Di Venere R, Pansini MV, Pellegrino A, Marello F, Nappi L. Advanced operative office hysteroscopy without anaesthesia: analysis of 501 cases treated with a 5 Fr. bipolar electrode. Hum Reprod. 2002;17:2435–2438. doi: 10.1093/humrep/17.9.2435. - DOI - PubMed
    1. Nagele F, O'Connor H, Davies A, Badawy A, Mohamed H, Magos A. 2500 Outpatient diagnostic hysteroscopies. Obstet Gynecol. 1996;88:87–92. doi: 10.1016/0029-7844(96)00108-1. - DOI - PubMed

Publication types