Prediction of Procedural Pain during Endometrial Biopsy

Abstract Background/Objective Endometrial (EM) biopsy is a commonly-performed gynecological procedure that is associated with side effects such as discomfort and pain. The aim of the current study was to predict procedural pain during EM biopsy. Methods We retrospectively reviewed the medical records of 100 women who underwent EM biopsy between July 2014 and November 2015 in an outpatient clinic of our hospital. Eighty-one patients were included in the final analysis after excluding those who lacked pain data and those who were sedated with midazolam. We examined the association of patient and clinician characteristics with procedural pain, and created a prediction model using characteristics via multiple linear regression analysis. Results Eighty-one women underwent EM biopsy (dilatation and curettage, EM sampling). In univariable analysis, history of EM biopsy, endometrial thickness (EMT) and training year of operator (TY) were significantly associated with procedural pain. The initial multivariable model was fitted with significant predictors in a univariable analysis. The p-value of EMT and TY was below the pre-defined threshold (0.2) and the final pain prediction model included EMT and TY. Furthermore, pain during the procedure was calculated by the following equation: pain score (numeric rating scale) = 7.364 + (−0.872) * EM thickness (cm) + (−1.033)*TY. Conclusion Both endometrial thickness and training year of operator were useful predictors of the severity of EM biopsy-related pain.