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

Results: both Laminaria and Evening Primrose 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 Primrose Oil group (123 seconds vs 55 seconds, P-value 0.01). The ease of cervical dilation was likewise significantly better for the Evening Primrose Oil group (26.19% vs 16.67%, P-value 0.04).

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

Human ; Operative Hysteroscopy ; Cervical Priming ; Laminaria Tents ; Evening Primrose Oil

OBJECTIVE

This study aimed to determine the efficacy of evening primrose oil versus dinoprostone gel as a cervical priming agent prior to operative hysteroscopy.

METHODOLOGY

Nine patients were randomixed to receive either oral Evening Primrose Oil 1000mg/capsule one capsule three times a day for 7 days (n=4) versus 500 mcg intracervical dinoprostone gel 12 hours (n=5)prior to the procedure. The primary outcome measures were baseline cervical width prior to operative hysteroscopy. The secondary outcomes were surgeons' subjective assessments for insertion difficulty, number of patients requiring cervical dilatation, duration of cervical dilatation, pre-operative pain, adverse effects and complications.

RESULTS

Both agents, Evening primrose oil and dinoprostone gel, were effective for cervical dilatation with a mean cervical diameter of 8.0+1.4 mm and 8.2+1.3 mm, respectively (P=0.832). There are no significant difference in the mean cervical diameter, ease of insertion of operative hysteroscope, time required for and number of patients requiring cervical dilatation. More patients in the dinoprostone complained of hypogastric pain prior to the procedure. No perioperative complications were observed in both groups.

CONCLUSION

Both oral Evening primrose oil and intracervical dinoprostone gel were equally effective in inducing proper cervical priming prior to operative hysteroscopy. Nevertheless, Evening primrose oil may be superior due to its oral route, reduced cost, patient convenience and acceptability.

Dinoprostone ; Evening Primrose Oil

Objective: The purpose of this study was to determine the efficacy of Evening Primrose Oil as a cervical ripening agent when used prior to operative hysteroscopy. Study Design: A randomized, double-blind, placebo-controlled trial included a total of 42 patients randomly assigned to the Evening Primrose Oil group (24) and to the placebo group (18). The primary outcome was initial cervical dilatation prior to hysteroscopy. The number of patients requiring cervical dilatation and duration of cervical dilatation to Hegar dilator size 10 were included as secondary outcomes. Results: There was a statistical and clinically significant difference between the initial cervical dilatation in the treatment and placebo groups (7.81 mm vs. 4.33mm). All patients in the placebo group required cervical dilatation prior to hysteroscopy while only 47.62 percent of patients in the treatment group required any dilatation. It took an average of 53.56 seconds to dilate the cervix to Hegar size 10 in the placebo group compared to 17.43 seconds in the treatment group. Conclusion: Similar to trials in pregnant patients, this study proved that Evening Primrose Oil can be used as a cervical priming agent prior to gynecologic procedures.
EVENING PRIMROSE OIL ; CERVICAL PRIMING ; HYSTEROSCOPY