Objective: The purpose of this study was to assess the clinical outcomes of using a combination of oral Ketoprofen and vaginal isonicotinic acid hydrazide (INH) for pain management during hysterosalpingography (HSG) vs using solely oral Ketoprofen.
Methods: The randomized controlled study was conducted between August 2020 and September 2021. Infertile women scheduled for HSG were randomized (1:1) to Ketoprofen with or without INH. All women received oral 150 mg Ketoprofen plus 900 mg vaginal INH or placebo tablets 12 hours before the procedure. The primary outcome was the participant's self-rated pain perception utilizing a 10-cm Visual Analogue Scale (VAS). During speculum insertion, cervical tenaculum application, dye injection, and 5 and 30 minutes following the procedure, the participants' self-rat- ed pain was assessed using a 10-cm VAS.
Results: A total of 200 women participated (100 in each group). Oral Ketoprofen combined with vaginal INH substantially lowers the major VAS pain ratings during dye injection (4.23 ± 0.89 vs. 6.18 ± 0.90), 5-minute post-procedure (3.05 ± 0.95 vs. 5.81 ± 0.91), and 30-minute post-procedure (2.14 ± 0.74 vs. 4.69 ± 0.80), with p 0.01 at all phases. After using a speculum or tenaculum, there were no significant differences in VAS values. In terms of side effects, there was no significant difference between the study groups.
Conclusion: Adjuvant vaginal INH to oral Ketoprofen 12 hours before HSG may be considerably more effective than Ketoprofen alone in reducing the caused pain score during and 30 minutes after the HSG procedure.