Gynaecological Cancer Research Centre, Women's Cancer, UCL EGA Institute for Women's Health, London, UK.
Ultrasound Obstet Gynecol. 2013 Jan;41(1):73-9. doi: 10.1002/uog.12262. Epub 2012 Dec 11.
To assess pain and overall experience of transvaginal sonography (TVS) in asymptomatic postmenopausal women.
In the United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS), 50 639 postmenopausal women were randomized to undergo annual TVS at 13 trial centers in England, Wales and Northern Ireland. Together with the appointment letter for their annual scan, a random sample of 150 women per center was sent a detailed 48-item postal questionnaire regarding the screening experience. It included a specific question about pain using a score of 0-5, where 5 was severe pain and 3 was discomfort. To assess factors that might affect a woman's reported pain experience, the pain score was regressed on age, hormone replacement therapy use, body mass index, a history of hysterectomy, prolonged scanning time, ovarian visualization, scan result, sonographer's visualization rates and opinion of the women regarding the sonographer who performed the scan.
Between 7 July and 9 September 2009, 1950 randomly chosen women (150 per regional center) were sent the questionnaire. Of the 800 (41.0%) who returned the questionnaire, 651 could be linked to their TVS appointment. One-hundred and fifty-two (23.3%) women reported pain/discomfort (score 3-5) during TVS and 473 (72.7%) reported no discomfort (score 0-2). Only 23 (3.5%) women reported experiencing moderate/severe pain. Increasing discomfort/pain was independently associated with a history of hysterectomy and participant's reporting of prolonged scan time. Women who experienced pain on TVS were less compliant (odds ratio = 0.87) with the following year's scan compared with those who did not experience pain.
The majority of postmenopausal women found TVS acceptable. Pain influenced compliance and correlated with women's perception of increased scanning time and previous hysterectomy.
评估无症状绝经后妇女经阴道超声检查（TVS）的疼痛和整体体验。
在英国卵巢癌筛查协作试验（UKCTOCS）中，50639 名绝经后妇女被随机分配至英格兰、威尔士和北爱尔兰的 13 个试验中心，每年接受一次 TVS。与年度扫描预约信一起，每个中心随机抽取 150 名妇女，发送一份关于筛查体验的详细 48 项邮寄问卷。其中包括一个关于疼痛的特定问题，使用 0-5 分制评分，5 分为剧烈疼痛，3 分为不适。为了评估可能影响女性报告疼痛体验的因素，将疼痛评分回归到年龄、激素替代疗法使用、体重指数、子宫切除术史、扫描时间延长、卵巢可视化、扫描结果、超声医师的可视化率以及接受扫描的超声医师的意见。
2009 年 7 月 7 日至 9 月 9 日期间，随机选择了 1950 名妇女（每个区域中心 150 名）发送问卷。在 800 名（41.0%）返回问卷的妇女中，有 651 名可与 TVS 预约相关联。152 名（23.3%）妇女报告在 TVS 检查期间有疼痛/不适（评分 3-5），473 名（72.7%）报告无不适（评分 0-2）。只有 23 名（3.5%）妇女报告经历了中度/重度疼痛。不适感增加与子宫切除术史和参与者报告的扫描时间延长独立相关。经历 TVS 疼痛的女性对下一年扫描的依从性较低（比值比=0.87）。
大多数绝经后妇女认为 TVS 可接受。疼痛影响了依从性，并与女性对扫描时间延长和先前子宫切除术的感知相关。
