Warming Echovist contrast medium for hysterocontrastsonography and the effect on the incidence of pelvic pain. A randomized controlled study.

BACKGROUND Hysterocontrastsonography (HyCoSy) is a simple effective investigation of tubal patency. One common side effect is pelvic pain at the time of the procedure. The temperature of the contrast media used may be a causative agent for pelvic pain. This study was designed to assess the effect of warming the contrast to body temperature compared to room temperature on the incidence of pelvic pain. METHODS A randomized controlled trial was carried out at the Cardiff Assisted Reproduction Unit. Following ethical approval, all women having HyCoSy for tubal assessment were asked if they would be willing to participate in the study. Computer-generated numbers were placed in opaque sealed envelopes, which were opened by the fertility nurse at the time of procedure. The women were randomized into two arms to receive the contrast medium at either room temperature or at body temperature. Randomization was done according to CONSORT guidelines. The pain experienced was then recorded by the patient on a 10-cm visual analogue scale. RESULTS The mean pain scores in the room temperature and the body temperature arms were 5.1 and 3.86, respectively. This was statistically significant (P = 0.006). CONCLUSION Warming of Echovist contrast media to body temperature is a simple and effective intervention in reducing discomfort at the time of HyCoSy.