OBJECTIVES: To compare the efficacy of Luminaria versus Evening Primrose Oil as cervical ripening agent prior to operative hysterectomy.

MATERIALS AND METHODS: A randomized controlled trial carried out in a university hospital from April to August 2015. The Luminaria group patients received a single intracervical Laminaria tent (2-3 mm in diameter) 12 hours prior to the hysteroscopic procedure. The Evening Primerose Oil group of patients received 6 intravaginal Evening Primerose Oil capsules inserted into the posterior fornix 6 hours prior the procedure followed by another 4 capsules inserted 1 hour prior to the procedure.

RESULTS: Both Laminaria and Evening Primerose Oil were effective in dilating the cervix, but the initial cervical dilation was significantly greater for the Laminaria group. The median duration of time needed to insert the 10mm Hegar's dilator was significantly longer for the Laminaria tent group, compared to the Evening Primerose Oil group (123 seconds s 55 seconds, P-value 0.01). The ease of cervical dilation was likewise significantly better for the Evening Primerose Oil group (26.19% vs 16.67%, P-value 0.04).

CONCLUSION: Both Evening Primerose Oil and Laminara were effective in dilating the cervix. However, Evening Primerose Oil resulted in easier and faster cervical dilation required for hysterectomy. Evening Primerose Oil had better patient acceptability because it was more convenient and easier to use, and is less expensive, compared to Laminaria tents. Therefore , Evening Primerose Oil capsules is an easy-to-use regimen that can be recommended for patients undergoing operative hysterectomy, to facilitate easier and faster cervical dilation, and reduce compilations associated with resectoscope entry.