Pain During Outpatient HysteroscopyNCT07773376
Warm Versus Room Temperature Saline as a Uterine Distension Medium for Pain Reduction in Women Undergoing Outpatient Hysteroscopy: Protocol for a Randomized Controlled Trial
A study testing Warmed Saline at 37 degrees celsius and Room-Temperature Normal Saline in people with Pain During Outpatient Hysteroscopy and Pain Reduction in Outpatient Hysteroscopy, run by Reem Mohamed at 1 site in Egypt.
Trial summary
The goal of this randomized clinical trial is to determine whether using warmed saline at 37°C during outpatient diagnostic hysteroscopy can reduce pain compared with room-temperature saline. The study will include women aged 18 to 70 years who are undergoing outpatient diagnostic hysteroscopy. Read more about this study
- Who is it for?
- Ages 18 to 70 years, women onlyHealthy volunteers can take part
- Conditions the study is for
- Pain During Outpatient Hysteroscopy, Pain Reduction in Outpatient Hysteroscopy
- What is being tested?
- Warmed Saline at 37 degrees celsius and Room-Temperature Normal Saline
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 60 participants
- Where
- 1 siteEgypt
- Study dates
- Sep 2026to Dec 2026
- Phase
- Interventional
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 70 years
- Women only
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Age 18-70 years.
- Ability to understand and report pain using the Visual Analog Scale.
- Willingness to undergo outpatient hysteroscopy and provide written informed consent.
Who cannot join
- Congenital genital tract malformations: including these patients could introduce a confounding factor because pain may result from difficult anatomy rather than the temperature of the distension medium.
- Previous hysteroscopic procedures: pain perception may be influenced by prior experience rather than the intervention itself
- Suspected pregnancy: standard gynecologic practice considers pregnancy a contraindication to elective diagnostic hysteroscopy
- Active pelvic infection: instrumentation of an infected genital tract may increase morbidity and facilitate ascending infection. Also, pain scores may reflect infection-related pain rather than procedural pain.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Egypt1 site
Ain Shams University Maternity Hospital
Cairo
Reem M Sadiq, MBBCh, +201113939778, reem_mohamed@med.asu.edu.eg
About this study
The goal of this randomized clinical trial is to determine whether using warmed saline at 37°C during outpatient diagnostic hysteroscopy can reduce pain compared with room-temperature saline. The study will include women aged 18 to 70 years who are undergoing outpatient diagnostic hysteroscopy. Participants will be randomly assigned to receive either warmed saline at 37°C or room-temperature saline as the fluid used to expand the uterine cavity during the procedure. Data collected will then be used to compare pain scores between the two groups during hysteroscopy and one hour after the procedure. The study will also assess whether participants require additional pain medication and whether the procedure is stopped because of severe pain. The main hypothesis is that warmed saline at 37°C will result in lower pain scores than room-temperature saline.
Read the detailed description
Outpatient diagnostic hysteroscopy is commonly performed for the evaluation of intrauterine abnormalities and other gynecological indications. Pain during hysteroscopy may be influenced by cervical manipulation, uterine distension, and uterine contractions. The temperature of the distension medium may influence patient discomfort during the procedure.
This study is a parallel-group superiority randomized controlled trial designed to compare warmed normal saline at 37°C with room-temperature normal saline as the uterine distension medium during outpatient diagnostic hysteroscopy.
Eligible participants will be women aged 18 to 70 years who are scheduled for outpatient diagnostic hysteroscopy and who are able to understand and report pain using a visual analog scale. Participants will provide written informed consent before enrollment.
A total of 60 participants will be randomized in a 1:1 ratio to one of two study groups. The intervention group will undergo hysteroscopy using normal saline warmed to 37°C. The comparison group will undergo hysteroscopy using normal saline at room temperature. The temperature of the saline will be monitored using an infrared thermometer.
Pain intensity during the hysteroscopy will be assessed using a 0-to-10 visual analog scale and will constitute the primary outcome of the study. Secondary outcomes will include pain intensity one hour after the procedure, the need for additional analgesia during or after the procedure, and the proportion of participants in whom the procedure is abandoned because of intolerable pain.
The study will be conducted in the outpatient Endoscopy Unit of Demerdash Maternity Hospital, Ain Shams University. Diagnostic hysteroscopy will be performed using a 5-mm Karl Storz hysteroscope by the same senior physician.
The study is designed to determine whether the use of warmed saline at 37°C provides a clinically meaningful reduction in pain compared with room-temperature saline during outpatient diagnostic hysteroscopy.
- Being tested
- Warmed Saline at 37 degrees celsius, Room-Temperature Normal Saline
- Keywords
- Outpatient hysteroscopy
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Warmed Saline at 37 degrees celsiusOther
Normal saline warmed to 37°C and used as the uterine distension medium during outpatient diagnostic hysteroscopy. The temperature of the saline will be monitored using an infrared thermometer before and during the procedure.
Room-Temperature Normal SalineOther
Normal saline at room temperature used as the uterine distension medium during outpatient diagnostic hysteroscopy.
| Study group | Role | What they receive |
|---|---|---|
| Warmed saline at 37 degrees celsius | Experimental | Participants randomized to this arm will undergo outpatient diagnostic hysteroscopy using normal saline warmed to 37°C as the uterine distension medium. The planned allocation is 30 participants. Receives: Other: Warmed Saline at 37 degrees celsius |
| Room-Temperature Saline | Active comparator | Participants randomized to this arm will undergo outpatient diagnostic hysteroscopy using normal saline at room temperature as the uterine distension medium. The planned allocation is 30 participants. Receives: Other: Room-Temperature Normal Saline |
What is being measured
The primary outcome is the main question the study is designed to answer.
Pain intensity during outpatient diagnostic hysteroscopy measured using the Visual Analog Scale (VAS)
Pain intensity will be assessed using a Visual Analog Scale (VAS) ranging from 0 to 10, where 0 represents no pain and 10 represents the worst pain imaginable. The VAS score recorded immediately after the hysteroscopy will be compared between participants receiving warmed normal saline at 37°C and those receiving room-temperature normal saline.
Measured: During the hysteroscopy procedure
Secondary outcomes (3)
Pain intensity one hour after outpatient diagnostic hysteroscopy measured using the Visual Analog Scale (VAS)
Pain intensity will be assessed one hour after completion of the hysteroscopy using a Visual Analog Scale (VAS) ranging from 0 to 10, where 0 represents no pain and 10 represents the worst pain imaginable. VAS pain scores will be compared between participants receiving warmed normal saline at 37°C and those receiving room-temperature normal saline.
Measured: 1 hour after completion of the hysteroscopy
Need for additional analgesia after outpatient diagnostic hysteroscopy
The need for additional analgesia will be recorded as a binary outcome according to whether the participant requires analgesic medication. The proportion of participants requiring additional analgesia will be compared between the warmed saline at 37°C group and the room-temperature saline group.
Measured: 1 hour after completion of the procedure
Proportion of procedures abandoned due to intolerable pain
The proportion of participants in whom outpatient diagnostic hysteroscopy is abandoned because of intolerable pain will be recorded and compared between the warmed saline at 37°C group and the room-temperature saline group.
Measured: During the hysteroscopy procedure
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted19 Aug 2026
- Study startSep 2026 (estimated)
- Primary completionDec 2026 (estimated)
- Study completionDec 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (8)Papers the sponsor has linked to this study.
- Other trials for Pain During Outpatient HysteroscopyStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind
- Who is masked
- Participant, Care provider, Outcomes assessor
- Enrolment
- 60 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Reem Mohamed
- Sponsor type
- University, hospital or other
- Collaborators
- Ain Shams Maternity Hospital, Ain Shams University
- Responsible party
- Sponsor-investigator, Reem Mohamed, Ain Shams University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07773376
- Sponsor's protocol ID
- FMASU MS 555/ 2026
- Status last verified
- Aug 2026
- First submitted
- 15 Aug 2026
- Last updated
- 19 Aug 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Publications
Tawfek ME, Hemeda HM, Ibrahim MA. Effectiveness of warm saline distension media on relieving pain in outpatient office hysteroscopy: a randomized controlled clinical trial. Journal of Gynecology & Reproductive Medicine. 2019;3(1):1-7.
De Silva PM, Smith PP, Cooper NAM, Clark TJ; Royal College of Obstetricians and Gynaecologists. Outpatient Hysteroscopy: (Green-top Guideline no. 59). BJOG. 2024 Dec;131(13):e86-e110. doi: 10.1111/1471-0528.17907. Epub 2024 Aug 19.
PubMed 39160077Kapur S, Gruber A, Sekar H, Mafuta J, Lodhi W, Sivashanmugarajan V, Yoong W. Does temperature of distending medium matter in outpatient hysteroscopy? A double-blinded cohort control observational study of room temperature versus warmed saline. J Obstet Gynaecol Res. 2020 Mar;46(3):485-489. doi: 10.1111/jog.14207. Epub 2020 Jan 28.
PubMed 31991520Issat T, Beta J, Nowicka MA, Durczynski A, Jakimiuk AJ. Pain assessment during outpatient hysteroscopy using room temperature versus warm normal saline solution as a distention medium - a prospective randomized study. Clin Exp Obstet Gynecol. 2017;44(3):359-363.
PubMed 29949273Evangelista A, Oliveira MA, Crispi CP, Lamblet MF, Raymundo TS, Santos LC. Diagnostic hysteroscopy using liquid distention medium: comparison of pain with warmed saline solution vs room-temperature saline solution. J Minim Invasive Gynecol. 2011 Jan-Feb;18(1):104-7. doi: 10.1016/j.jmig.2010.09.009.
PubMed 21195961Nair VG, Mahajan R, Aziz A, Tiwari S. Effectiveness of warm saline for pain relief in office hysteroscopy: a prospective randomized control trial. International Journal of Clinical Obstetrics and Gynaecology. 2020;4(4):85-88. DOI: 10.33545/gynae.2020.v4.i4b.628.
Baradwan S, Khalil M, Alshahrani MS, Albouq B, AlSghan R, Khadawardi K, Mohamed DF, Yousef DH, Kamal SHM, Abdel Halim HW, Elhawary MAA, Alkholy EA, Elsharkawy MRM, Abdelhakim AM, Abbas AM, Dahshan SA, Alshawadfy A, Soror GI. Warm saline effectiveness for pain relief in office hysteroscopy: A systematic review and meta-analysis of randomized controlled trials. J Obstet Gynaecol Res. 2022 Jul;48(7):1523-1530. doi: 10.1111/jog.15272. Epub 2022 Apr 24.
PubMed 35466496Abdallah KS, Gadalla MA, Breijer M, Mol BWJ. Uterine distension media for outpatient hysteroscopy. Cochrane Database Syst Rev. 2021 Nov 26;11(11):CD006604. doi: 10.1002/14651858.CD006604.pub2.
PubMed 34826139