Chronic pelvic pain assessment and treatment, central sensitisation and pain after surgery, pain relief for outpatient hysteroscopy (inhaled, local and oral), vaginoscopy, patient experience of office procedures.
This page is written for clinicians and referrers and is not advice for individual patients. If you are a patient, the plain-language pages are Pelvic pain, periods and gynaecology and Hysteroscopy .
Each week the literature is searched for new papers on chronic pelvic pain and hysteroscopy pain, screened to the few that meet the evidence bar, and each one is verified on PubMed before it is summarised. I read every entry and give one verdict: whether the paper changes what I tell patients or do in theatre, supports current practice, or leaves it unchanged. Papers appear here newest first, grouped by the week they were found, with the study design, the main result and its effect size, and the reason for the verdict. Abstracts are not reproduced; the summaries are my own.
Digest of 22 October 2026
Search window 20 to 22 October 2026
Music or virtual reality during outpatient hysteroscopy did not lower pain scores, but more women would accept a repeat
Non-blinded randomised controlled trial at a single tertiary hospital in Hong Kong: 210 women having outpatient hysteroscopy randomised 1:1:1 to virtual reality, music or neither, with pain on a 0 to 10 scale through the procedure.
Finding
The maximum pain score did not differ between the three groups (P=0.131). Acceptance of a future hysteroscopy in the same setting was higher with music (mean 8.8, SD 2.1; P=0.002) and with virtual reality (8.6, SD 1.6; P=0.009) than with neither (7.5, SD 2.7). The abstract gives no mean pain scores or confidence intervals.
No changemoderate evidence
Distraction did not reduce pain; the improved acceptance is a soft, unblinded outcome and costs little, so it supports offering music where women want it without changing practice.
What it means
Music or a headset will not take the pain of an outpatient hysteroscopy away, but women offered one were more willing to come back.
Conflicts of interest: No industry funding is stated in the abstract.
Reviewed by Mr Jan, .
Catch-up digest, 22 September 2026 to 19 October 2026
Seeding run over a longer window, written 19 October 2026
With a standard retrieval bag, dermoid cyst contents spilled inside the abdomen in about one in four women; none spilled with a fully enclosed device: multicentre randomised trial
Multicentre randomised superiority trial (NCT04406597) in four academic hospitals in Beijing; 119 premenopausal women aged 18 to 45 with a unilateral ovarian mass of 3 to 10 cm were randomised to cystectomy carried out inside a totally enclosed protective device or to conventional cystectomy with extraction in a standard retrieval bag; 105 were analysed (53 against 52) after exclusions.
Finding
Macroscopic spillage inside the abdomen, the primary outcome, occurred in 0 of 53 women with the device against 13 of 52 (25.0%, about one in four) with a standard bag (risk difference -25.0%, 95% CI -36.8% to -13.2%, P<0.001); the cyst ruptured during surgery about as often in both groups (32.1% against 25.0%, risk difference 7.1%, 95% CI -10.3% to 24.5%); operating times were similar and the device deployed successfully every time; over a median 34.5 months, 5 of 52 control women (9.6%, about one in ten) developed new chronic pelvic pain and none of the device group did.
Supports current practicemoderate evidence
Avoiding spillage of dermoid contents is standard careful technique and the trial shows why: one in four spills with a conventional bag, and late pelvic pain only in that arm; it is a small trial of a device whose availability outside China is not described, so it supports strict spillage avoidance rather than a particular product.
What it means
For a woman having a dermoid cyst removed by keyhole surgery, the useful fact is in the control arm: with a standard retrieval bag the cyst contents spilled inside the abdomen in about one in four, and about one in ten of that group went on to develop long-term pelvic pain, against none when the whole cyst was handled inside a sealed device.
Conflicts of interest: Publicly funded (Capital's Funds for Health Improvement and Research, Beijing, No. 2022-2-406); the device's maker is not named in the record.
Reviewed by Mr Jan, .
Every paper on this site's evidence pages is also available as open data at /evidence/papers.json. The search and screening rules are on the evidence index.
Last reviewed .Reviewed by Mr Haider Jan, Consultant Gynaecologist.
For patients: Pelvic pain, periods and gynaecology and Hysteroscopy
The plain-language pages on what the condition is, how I assess it and the choices, written for the women I see.
