Pain is the most frequent side effect of hysterosalpingography, with up to 72% – 80% of women reporting varying degrees of pain during and after the procedure.
Objective: To evaluate the efficacy of diclofenac for pain relief in infertile women undergoing hysterosalpingography.
Materials and Methods: This randomised controlled trial was conducted at the Radiology Departments and Infertility Clinics of the Federal Medical Centre, Yenagoa, and Niger Delta University Teaching Hospital, Okolobiri, both in Bayelsa State, Nigeria, from July 2021 – March, 2022. Three hundred and eighty infertile women undergoing hysterosalpingography were randomised into two groups. Women in Group I were administered diclofenac, while the women in Group II received placebo, prior to the procedure. Pain scores at different steps of the procedure were recorded using the Visual Analog and Numerical Rating Scales. Data were analysed using the Statistical Product and Service Solutions for Windows®, version 25. Student’s t-test was used to compare sample means, while the chi-square test was used to compare the proportion of women in the two study groups, who expressed pain at the different steps of the procedure.
Results: Insertion of speculum was the step associated with the least pain during the procedure, the mean pain score at this step being 1.14 ± 1.25. Instillation of contrast media had the highest mean pain score of 4.72 ± 2.13. The pain scores at all steps of the procedure, 30 minutes and 24 hours after the procedure, were significantly lower in the diclofenac group compared to the placebo group (p=0.001).
Conclusion: Diclofenac is superior to placebo for the control of hysterosalpingography-associated pain.