Valsalva maneuver to reduce pain during pipelle endometrial biopsy

The Effect of the Valsalva Maneuver on Pain and Procedure Success in Endometrial Biopsy: A Randomized Controlled Trial

Not applicable Interventional Prof. Dr. Cemil Tascıoglu Education and Research Hospital Organization · NCT07496905

This study will test whether doing a Valsalva maneuver (bearing down) during a pipelle endometrial biopsy can reduce pain and anxiety for adult women having endometrial sampling.

Quick facts

PhaseNot applicable
Study typeInterventional
Enrollment120 (estimated)
Ages18 Years to 55 Years
SexFemale
SponsorProf. Dr. Cemil Tascıoglu Education and Research Hospital Organization Academic / other
Locations1 site (Istanbul)
Trial IDNCT07496905 on ClinicalTrials.gov

What this trial studies

This randomized controlled trial compares pipelle endometrial sampling performed with the Valsalva maneuver versus the conventional method using a tenaculum. Adult women who meet inclusion criteria are randomly assigned to one of the two techniques, and clinicians record pain scores, procedure success, patient anxiety, and overall satisfaction. Primary outcomes are patient-reported pain during the procedure and technical success of the sampling; secondary outcomes include anxiety and satisfaction measures. The trial is conducted at Cemil Tascioglu City Hospital in Istanbul and excludes pregnant, postmenopausal, and other patients with predefined cervical or uterine conditions.

Who should consider this trial

Good fit: Ideal candidates are adult, reproductive-age women who need pipelle endometrial sampling for abnormal uterine bleeding and can follow instructions in Turkish.

Not a fit: Patients who are pregnant, postmenopausal, have a stenotic cervical os, acute cervicitis, severe anxiety, or uterine anatomy/pathology that affects sampling are unlikely to benefit or be eligible.

Why it matters

Potential benefit: If successful, this simple maneuver could lower procedure-related pain and anxiety and reduce the need for using a tenaculum during many pipelle samplings.

How similar studies have performed: The Valsalva maneuver has physiological rationale and has been used in other minor procedures, but randomized data directly comparing it to tenaculum use in pipelle biopsies are limited.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

-Endometrial sampling indication in reproductive age group of patients over 18 years of age, who can communicate in Turkish.

Exclusion Criteria:

* Patients under 18 years of age - postmenopausal
* Pregnancy
* Patients with known stenotic cervical os
* Patients with a history of acute cervicitis;
* Patients with intense anxiety;
* Need for simultaneous endocervical curettage;
* Need for general or local anesthesia
* Having used analgesic medication before the procedure;
* History of a known malignancy, uterine anomaly, or leiomyoma affecting the cervical canal or uterine cavity, or uterine prolapse;
* Patients with known chronic plevic pain

Where this trial is running

Istanbul

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Pain in Endometrial BiopsyAbnormal Uterine Bleedingendometrial biopsyvalsalva maneuverPain
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.