From the Division of Female Pelvic Medicine and Reconstructive Surgery, TriHealth.
TriHealth Hatton Research Institute, Cincinnati, OH.
Female Pelvic Med Reconstr Surg. 2021 Mar 1;27(3):208-213. doi: 10.1097/SPV.0000000000000975.
This study was conducted to assess the utility of a mirror in improving pain and vulnerability during a pelvic examination.
In this prospective, institutional review board-approved, 2-cohort trial, all "new" patients presenting to a urogynecology office were offered to have a mirror or no-mirror present during their pelvic examination. Patients completed 100-mm visual analog scales regarding pain, anxiety, knowledge, control, embarrassment, and vulnerability before and after examination. The primary outcome was difference in level of pain and vulnerability between groups. Secondary outcomes included comparisons from baseline to postexamination scores within groups, patient satisfaction, and examination duration. A sample size of 68 participants in each arm was planned.
From April 2019 to May 2020, 147 participants were enrolled. Two participants were excluded, 145 were included in the final analysis; 74 in the no-mirror group and 71 in the mirror group. The average age was 55.9 (±13) years, and the groups were overall similar. There was no difference in primary outcomes of pain or vulnerability, but the mirror group showed improved levels of control (P = 0.006) and knowledge (P = 0.018) following examination. All participants reported high satisfaction, and those that selected a mirror reported strong preference for future use.
Patients who chose to use the mirror did not demonstrate a difference in pain or vulnerability scores; however, they exhibited benefit to their sense of control and knowledge after the pelvic examination. Although the mirror did not benefit all patients, this is a simple option that could improve the examination experience for some.Clinical Trial Registration:ClinicalTrials.gov, NCT03785548.
本研究旨在评估镜子在改善骨盆检查时的疼痛和脆弱感方面的效用。
在这项前瞻性、机构审查委员会批准的、两队列试验中，所有向泌尿科就诊的“新”患者都被提供在骨盆检查时使用或不使用镜子的选择。患者在检查前后使用 100 毫米视觉模拟量表评估疼痛、焦虑、知识、控制感、尴尬感和脆弱感。主要结局是两组间疼痛和脆弱感水平的差异。次要结局包括组内从基线到检查后评分的比较、患者满意度和检查持续时间。计划每组纳入 68 名参与者。
2019 年 4 月至 2020 年 5 月，共纳入 147 名参与者。排除 2 名参与者，最终有 145 名参与者纳入最终分析；无镜组 74 名，有镜组 71 名。平均年龄为 55.9（±13）岁，两组总体相似。主要结局（疼痛或脆弱感）无差异，但检查后镜组的控制感（P=0.006）和知识（P=0.018）水平有所改善。所有参与者报告高度满意，选择使用镜子的参与者表示强烈希望未来使用。
选择使用镜子的患者在疼痛或脆弱感评分方面没有差异；然而，他们在骨盆检查后对控制感和知识的认知有所提高。虽然镜子并非对所有患者都有益，但这是一种简单的选择，可以改善一些患者的检查体验。
ClinicalTrials.gov，NCT03785548。
