Quantifying procedural pain associated with office gynecologic tract sampling methods.

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  • Additional Information
    • Source:
      Publisher: Academic Press Country of Publication: United States NLM ID: 0365304 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1095-6859 (Electronic) Linking ISSN: 00908258 NLM ISO Abbreviation: Gynecol Oncol Subsets: MEDLINE
    • Publication Information:
      Original Publication: New York, Academic Press.
    • Subject Terms:
      Menstrual Hygiene Products*; Biopsy/*instrumentation ; Cytodiagnosis/*instrumentation ; Endometrial Neoplasms/*diagnosis ; Endometrium/*cytology ; Pain, Procedural/*diagnosis; Biopsy/adverse effects ; Biopsy/methods ; Cytodiagnosis/adverse effects ; Cytodiagnosis/methods ; Endometrial Neoplasms/pathology ; Endometrium/pathology ; Female ; Humans ; Middle Aged ; Pain, Procedural/prevention & control ; Prospective Studies
    • Abstract:
      Objective: Emerging technologies may enable detection of endometrial cancer with methods that are less invasive than standard biopsy methods. This study compares patient pain scores among 3 office gynecologic tract sampling methods and explores their potential determinants.
      Methods: A prospective study including 3 sampling methods (tampon, Tao brush (TB), endometrial biopsy (EB)) was conducted between December 2015 and August 2017 and included women ≥45 years of age presenting with abnormal uterine bleeding, postmenopausal bleeding, or thickened endometrial stripe. Patients rated pain after each sampling procedure using a 100-point visual analog scale (VAS).
      Results: Of 428 enrolled, 190 (44.39%) patients underwent all 3 sampling methods and reported a VAS score for each. Nearly half were postmenopausal (n = 93, 48.9%); the majority were parous (172, 90.5%) of which 87.8% had at least one vaginal delivery. Among the 190 patients, the median (IQR) pain score was significantly lower for sampling via tampon (0 [0,2]) compared to TB (28 [12, 52]) or EB (32 [15, 60]) (both p < 0.001, Wilcoxon signed rank test). Among women who underwent tampon sampling, age and pain scores showed a weak positive correlation (Spearman rank correlation, r = 0.14; p = 0.006); EB sampling was associated with a weak inverse correlation between parity and pain scores (r = -0.14; p = 0.016).
      Conclusion: Gynecologic tract sampling using a tampon had significantly lower pain than both EB and TB. Pain with tampon sampling was positively correlated with age and pain with EB sampling was inversely correlated with parity. Pain scores for TB and EB were not significantly related to age, menopausal status, or BMI.
      Competing Interests: Declaration of Competing Interest Dr. Bakkum-Gamez has an intellectual property disclosure filed on endometrial cancer methylated DNA markers with Mayo Clinic Ventures (Rochester, MN) and Exact Sciences (Madison, WI).
      (Copyright © 2021 Elsevier Inc. All rights reserved.)
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    • Grant Information:
      P30 CA015083 United States CA NCI NIH HHS; Z01 CP010124 United States ImNIH Intramural NIH HHS
    • Contributed Indexing:
      Keywords: Abnormal uterine bleeding; Endometrial biopsy; Postmenopausal bleeding; Procedural pain; Tampon; Tao brush
    • Publication Date:
      Date Created: 20210507 Date Completed: 20211230 Latest Revision: 20220716
    • Publication Date:
      20231215
    • Accession Number:
      PMC8222179
    • Accession Number:
      10.1016/j.ygyno.2021.04.033
    • Accession Number:
      33958213