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Rev Bras Ginecol Obstet. 2007;29(4):181-185
DOI 10.1590/S0100-72032007000400003
PURPOSE: to determine the efficacy of 10% lidocaine spray applied to the cervix before the procedure of diagnostic hysteroscopy, in order to reduce the painful process and the discomfort caused by the exam. METHODS: a total of 261 consecutive patients participated in the study, which was conducted from March 2004 to March 2005. The patients were randomly assigned to one of two groups: one group receiving topical lidocaine spray (lidocaine group - LdG) and the other, receiving no medication before the procedure (control group - CG). In the LdG patients, thirty milligrams of 10% lidocaine spray were applied to the surface of the cervix five minutes before hysteroscopy started. Immediately, after the end of the procedure, the patients from both groups were asked to respond to a questionnaire about pain and to quantify the pain, in centimeters, using a 10-cm non-graduated visual analog scale. The unpaired t test, the Mann-Whitney test and the chi2 test were used for statistical analyses, considering p significant if lower than 0.05. RESULTS: there was no statistically significant difference between groups regarding age, parity or percentage of patients in menacme or menopause, or regarding the indications for the procedure and the hysteroscopic findings. A biopsy was necessary in 57 of the 132 LdG patients and in 48 of the 129 CG patients (p=0.96). The mean pain score was 4.3±2.9 in LdG and 3.9±2.5 in CG (p=0.2). A difference in the mean pain score was observed only among patients in menacme and menopause receiving or not the lidocaine spray, with p=0.01 and p=0.04 respectively. CONCLUSIONS: the use of lidocaine spray during diagnostic hysteroscopy does not minimize the discomfort and pain of the patients and therefore should not be applied.
Summary
Rev Bras Ginecol Obstet. 2007;29(4):181-185
DOI 10.1590/S0100-72032007000400003
PURPOSE: to determine the efficacy of 10% lidocaine spray applied to the cervix before the procedure of diagnostic hysteroscopy, in order to reduce the painful process and the discomfort caused by the exam. METHODS: a total of 261 consecutive patients participated in the study, which was conducted from March 2004 to March 2005. The patients were randomly assigned to one of two groups: one group receiving topical lidocaine spray (lidocaine group - LdG) and the other, receiving no medication before the procedure (control group - CG). In the LdG patients, thirty milligrams of 10% lidocaine spray were applied to the surface of the cervix five minutes before hysteroscopy started. Immediately, after the end of the procedure, the patients from both groups were asked to respond to a questionnaire about pain and to quantify the pain, in centimeters, using a 10-cm non-graduated visual analog scale. The unpaired t test, the Mann-Whitney test and the chi2 test were used for statistical analyses, considering p significant if lower than 0.05. RESULTS: there was no statistically significant difference between groups regarding age, parity or percentage of patients in menacme or menopause, or regarding the indications for the procedure and the hysteroscopic findings. A biopsy was necessary in 57 of the 132 LdG patients and in 48 of the 129 CG patients (p=0.96). The mean pain score was 4.3±2.9 in LdG and 3.9±2.5 in CG (p=0.2). A difference in the mean pain score was observed only among patients in menacme and menopause receiving or not the lidocaine spray, with p=0.01 and p=0.04 respectively. CONCLUSIONS: the use of lidocaine spray during diagnostic hysteroscopy does not minimize the discomfort and pain of the patients and therefore should not be applied.
Summary
Rev Bras Ginecol Obstet. 2007;29(2):96-102
DOI 10.1590/S0100-72032007000200007
PURPOSE: to evaluate the classification and the etiology of girls attended in a Pediatric and Adolescent Gynecology Clinic. METHODS: The hospital charts of 58 female patients attended from 2000 to 2005 with diagnosis of probable precocious puberty were reviewed and relevant data analyzed. Inclusion criteria were breast and/or pubic hair growth before eight years old. The girls were classified according to the clinic aspects and the supplementary exams they had been submitted to, into one of the categories: central precocious puberty (CPP), precocious pseudopuberty, premature thelarche and premature pubarche. RESULTS: from the 58 reviewed cases, 28 girls were diagnosed as CPP, one as precocious pseudopuberty, ten as premature thelarche and 19 as premature pubarche. All the cases of CPP had an idiopathic etiology, except for one girl whose activation of the ypothalamic-pituitary-gonadal axis was secondary to congenital adrenal hyperplasia. There was one case of precocious pseudopuberty due to McCune-Albright syndrome. All the cases of premature thelarche had an idiopathic etiology, except for one girl who had primary hypothyroidism. All the cases of premature pubarche had an idiopathic etiology. CONCLUSIONS: among the cases diagnosed as precocious puberty, CPP was the leading diagnosis and most cases had an idiopathic etiology. Organic causes leading to precocious puberty were infrequent.
Summary
Rev Bras Ginecol Obstet. 2007;29(2):96-102
DOI 10.1590/S0100-72032007000200007
PURPOSE: to evaluate the classification and the etiology of girls attended in a Pediatric and Adolescent Gynecology Clinic. METHODS: The hospital charts of 58 female patients attended from 2000 to 2005 with diagnosis of probable precocious puberty were reviewed and relevant data analyzed. Inclusion criteria were breast and/or pubic hair growth before eight years old. The girls were classified according to the clinic aspects and the supplementary exams they had been submitted to, into one of the categories: central precocious puberty (CPP), precocious pseudopuberty, premature thelarche and premature pubarche. RESULTS: from the 58 reviewed cases, 28 girls were diagnosed as CPP, one as precocious pseudopuberty, ten as premature thelarche and 19 as premature pubarche. All the cases of CPP had an idiopathic etiology, except for one girl whose activation of the ypothalamic-pituitary-gonadal axis was secondary to congenital adrenal hyperplasia. There was one case of precocious pseudopuberty due to McCune-Albright syndrome. All the cases of premature thelarche had an idiopathic etiology, except for one girl who had primary hypothyroidism. All the cases of premature pubarche had an idiopathic etiology. CONCLUSIONS: among the cases diagnosed as precocious puberty, CPP was the leading diagnosis and most cases had an idiopathic etiology. Organic causes leading to precocious puberty were infrequent.