DR MEHAK , DR MAHLIQA MAQSUD , DR DANIYAL SAQIB ALVI
DOI: https://doi.org/10.5281/zenodo.19706227Background: Diagnostic hysteroscopy is the gold standard to assess intrauterine pathology. Nevertheless, cervical dilatation is a life-threatening procedure, which is accompanied by pain and complications. Pharmacological medications are commonly used to cervical priming (misoprostol) and phloroglucinol, a spasmolytic agent, has been developed as a possible alternative.
Objective: To determine the difference in the outcome between intramuscular phloroglucinol and oral misoprostol before diagnostic hysteroscopy in premenopausal women.
Methodology: This was a randomized controlled trial done in the Department of Gynecology and Obstetrics, Services hospital from August 2025 to November 2025. One hundred and ten premenopausal women (40-45 years old) who were in diagnostic hysteroscopy were enrolled and randomly sampled out of 110 women (n=55) into two groups by lottery method. Group A was pre-proceded with 80 mg of intramuscular phloroglucinol 30 minutes before the procedure and Group B with 400 µg oral misoprostol 2 hours before. Measures of outcome were mean cervical dilatation, pain evaluation by Visual Analog Scale (VAS) and cervical passage time. Data analysis was done with SPSS v25. Independent sample t-test was used and the p=0.05 was taken to be significant.
Results: The phloroglucinol group (mean of 8.10 mm 0.80 mm) had a higher cervical width than the misoprostol group (mean of 6.70 mm 1.45 mm; p<0.001). The mean VAS pain score was significantly lower in Group A (0.60±0.90) versus Group B (2.60±2.10; p<0.001). Phloroglucinol (19.2±7.5 sec) also had a shorter cervical passage time than misoprostol (24.1±8.0 sec; p=0.002).
Conclusion: Intramuscular phloroglucinol is superior to oral misoprostol in enhancing cervical dilatation and pain reduction, and reduces the length of procedure in diagnostic hysteroscopy. It is an effective and safe substitute of cervical priming.
