Pain perceived during hysteroscopic morcellation by vaginoscopy versus standard technique in an outpatient setting: a randomized controlled trial
Bibliographic record
Abstract
OBJECTIVE: To compare pain perceived in women undergoing polyp or fibroid morcellation with a 5.5 mm MyoSure hysteroscope by vaginoscopy vs standard technique, both under sedation in an outpatient setting. SUBJECTS: Women between the ages 18-52 years; with a clear indication for operative hysteroscopy such as a polyp or type 0/1 fibroid measuring <2 cm, or <4 cm total when more than one lesion was present. METHOD: Randomized controlled trial. Patients were randomized into two groups: Group 1 underwent hysteroscopic morcellation using the standard technique, while Group 2 underwent the procedure via vaginoscopy. The primary outcome measured was the participants' self-rated pain perception using the 10-point visual analog scale. The secondary outcomes included duration of the intervention, blood loss, complication at one week follow-up and pregnancy rate at 6 and 12 months. The study was conducted in an outpatient fertility clinic in a tertiary university hospital. RESULTS: A total of 78 patients were included in the final analysis, with 39 patients per group. Participant baseline characteristics were similar in each group. In an intention-to-treat analysis, the standard technique was found to be significantly less painful than vaginoscopy (mean score 4.0 vs 5.9; difference in means 1.9; p = 0.001). No differences were demonstrated for operative time, postprocedural bleeding, or complication rate. Pregnancy outcomes, including pregnancy rate and pregnancy loss at 6 and 12 months, were not statistically different between the two groups. CONCLUSION: Standard technique for polyps or fibroids removal is less painful than vaginoscopy in women under sedation in an outpatient setting using 5.5 mm MyoSure hysteroscope. Therefore, it should be considered the technique of choice.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.007 | 0.003 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.003 | 0.004 |
| Insufficient payload (model declined to judge) | 0.011 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".