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CC BY-NC-ND 4.0 · Endosc Int Open 2021; 09(07): E1055-E1061
DOI: 10.1055/a-1464-0780
Original article

Efficacy of a small-caliber colonoscope for pain in female patients during unsedated colonoscopy: a randomized controlled study

Yasuhiko Hamada
1   Department of Gastroenterology and Hepatology, Mie University Hospital, Tsu, Japan
,
Kyosuke Tanaka
2   Department of Endoscopy, Mie University Hospital, Tsu, Japan
,
Masaki Katsurahara
2   Department of Endoscopy, Mie University Hospital, Tsu, Japan
,
Noriyuki Horiki
2   Department of Endoscopy, Mie University Hospital, Tsu, Japan
,
Reiko Yamada
1   Department of Gastroenterology and Hepatology, Mie University Hospital, Tsu, Japan
,
Junya Tsuboi
2   Department of Endoscopy, Mie University Hospital, Tsu, Japan
,
Misaki Nakamura
1   Department of Gastroenterology and Hepatology, Mie University Hospital, Tsu, Japan
,
Satoshi Tamaru
3   Clinical Research Support Center, Mie University Hospital, Tsu, Japan
,
Tomomi Yamada
4   Department of Medical Innovation, Osaka University Hospital, Suita, Japan
,
Yoshiyuki Takei
1   Department of Gastroenterology and Hepatology, Mie University Hospital, Tsu, Japan
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Abstract

Background and study aims Female sex has been identified as a factor increasing patients’ pain during colonoscopy. The aim of this randomized controlled study was to investigate the efficacy of a small-caliber colonoscope, PCF-PQ260 L, for limiting pain in women during unsedated colonoscopy.

Patients and methods Women who underwent unsedated colonoscopy were randomly allocated to either the small-caliber or standard colonoscope group. The primary outcome was overall pain and secondary outcomes were maximum pain and procedural measures. In addition, the effects of colonoscope type were analysed using analysis of covariance and logistic regression with adjustment for stratification factors, age and prior abdomino-pelvic surgery.

Results A total of 220 women were randomly assigned to the small-caliber (n = 110) or standard (n = 110) colonoscope groups. Overall and maximum pain scores were significantly lower in the small-caliber colonoscope group than the standard colonoscope group (overall pain, 20.0 vs. 32.4, P < 0.0001; maximum pain, 28.9 vs. 47.2, P < 0.0001). The small-caliber colonoscope group achieved a superior cecal intubation rate (99 % vs. 93 %, P = 0.035). The rate of patient acceptance of unsedated colonoscopy in the future was higher in the small-caliber colonoscope group than in the standard colonoscope group (98 % vs. 87 %, P = 0.003). In addition, the small-caliber colonoscope was superior with respect to reducing pain and improving the rate of patient acceptance of unsedated colonoscopy with adjustment.

Conclusions This study demonstrates the efficacy of the small-caliber colonoscope for reducing pain in women and improving their rate of acceptance of unsedated colonoscopy.



Publication History

Received: 25 September 2020

Accepted: 02 March 2021

Article published online:
17 June 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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