Comparison of Level of Pain between Using Manual Vacuum Aspiration and Sharp Curettage in Management of Abnormal Uterine Bleeding
Arthit Boonyarangkul MD*, Orawan Leksakulchai MD*
Affiliation : * Department of Obstetrics and Gynecology, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
Objective : To compare the level of pain between using manual vacuum aspiration and sharp curettage in the patients who had
abnormal uterine bleeding that underwent uterine curettage under paracervical block with analgesics.
Design : Randomized controlled trial study.
Material and Method: Between September 2009 to June 2010, 48 women with abnormal uterine bleeding who need to
undergone uterine curettage were asked to join the present study and informed consents were signed. Twenty four women
were randomly assigned into manual vacuum aspiration (MVA) group and other 24 women into sharp curettage group. The
main outcome was the difference of the level of pain before, during and after procedure measured by using the visual analog
scale and categorical pain scores. Fisher exact, Student t test and Mann-Whitney U test were used for statistical analysis.
Results : The median visual analog score during MVA-procedure was significantly lower than the median visual analog score
during in sharp curettage (median visual analog pain scores (interquartile range) 80 (30-100) vs. 45 (0-80); p < 0.01)). And
the median score immediately after procedure in the MVA group was also significantly lower than in the sharp curettage group
(median visual analog pain scores (interquartile range) 45 (0-80 vs. 25 (0-70); p = 0.02). The categorical pain score in the
MVA group during procedure and immediately after procedure were also significantly lower than in the sharp curettage
group. (No pain to mild pain vs. moderated to severe pain; p = 0.03, immediately after procedure: no pain to mild pain vs.
moderated to severe pain; p = 0.01).
Conclusion : The level of pain in the patients who underwent uterine curettage by using MVA was lower than using sharp
curettage. The using MVA may reduce pain compared to sharp curettage. However, more sample size research should be
conducted to determine this significant.
Keywords : Manual vacuum aspiration, Sharp curettage, Visual analog scale
