Vaginal Isonicotinic Acid Hydrazide Prior to Diagnostic Office Hysteroscopy in Primarily Infertile Patients: A Randomized Double-Blinded Clinical Trial

Abstract

Objective: The aim of this research was to learn if 900 mg of vaginal isonicotinic acid hydrazide (INH) reduced pain and improved insertion ease during diagnostic outpatient hysteroscopy (DOH) in nulliparous infertile patients, when administered 12 hours before DOH. Materials and Methods: A double-blinded, randomized, controlled study was carried out at a university teaching hospital. Primary infertile women (150) were allocated randomly to receive 900 mg of INH vaginally or a placebo 12 hours before DOH for infertility assessment. Patients were requested to assess the intensity of their pain on a visual analogue scale ranging from 1 to 10 during the DOH, which was the study's primary objective. Secondary outcomes were the time it took to insert the hysteroscope via the external cervical os and to view the uterus, patient satisfaction, postprocedural analgesic needs, and the ease with which DOH was performed. Results: Both groups shared baseline features. The INH group had a reduced mean pain score during DOH (3.9 ± 0.8 versus 5.8 ± 0.8; p < 0.001). DOH was easier in the INH group; ease of insertion score in the INH group was lower than in the placebo group (5.3 ± 0.1 versus 7.3 ± 1.1; p < 0.001). The INH group had greater satisfaction (7.6 ± 1.3 versus 5.1 ± 0.9; p < 0.001) and needed less analgesia (p = 0.02) than the placebo group. Both groups had comparable adverse effects. Conclusions: In nulliparous infertile women, 900 mg of vaginal INH 12 hours before DOH reduces perceived pain more effectively than a placebo, facilitating easier hysteroscope insertion and improving patient satisfaction. (J GYNECOL SURG 20XX:000)