the effect of vaginal hyoscine butyl bromide versus vaginal misoprostol on cervical ripening before hysteroscopy: a randomized clinical trial

Background & objective: in situations where misoprostol is not available or its use is contraindicated, hyoscine can be an alternative option. the present study was conducted with aim to compare the effect of vaginal hyoscine butyl bromide and versus vaginal misoprostol on cervical ripening before hysteroscopy.materials & methods: this double-blind randomized clinical trial study was conducted on 150 patients who were candidates for diagnostic or therapeutic hysteroscopy and were divided into two groups. in group one, 75 patients received 20 mg of hyosin vaginally 4 hours before surgery, and in group 2, 200 micrograms of misoprostol was administered vaginally 4 hours before surgery. the two groups were compared in terms of passage of hegar dilator number 5, amount of cervical dilatation, operation length, postoperative pain and drug side effects. results: the passage rate of hegar dilator number 5 in the misoprostol group was 51 (68%) and in the hyoscine group was 44 (58.7%). also, the mean pain in the misoprostol group was 5.32±2.16 and in the hyosin group was 5.68±1.61. the mean operation length in the misoprostol group was 38.36±6.14 minutes and the in the hyosin group was 40.23±6.41 minutes. the mean amount of cervical dilatation in the misoprostol group was 5.43±1.53 cm and in the hyosin group was 4.97±1.44 cm. conclusion: hyoscine for cervical ripening for diagnostic and therapeutic hysteroscopy had no significant difference with misoprostol. also, there was no significant difference between the two groups in surgical complications, duration of surgery, postoperative pain, and the amount of cervical dilatation. therefore, considering the low cost and availability of hyoscine, its use for ripening the cervix before hysteroscopy seems logical.