Effect of intracervical block on self-reported intrauterine device insertion pain: a single-center prospective survey study.

Abstract

Objective: The study aimed to determine the incidence of self-reported pain during office-based intrauterine device (IUD) placement.

Methods: The study included patients who had IUD placement at our clinic from April 1, 2023, to March 31, 2024 with no prior history of vaginal delivery, who were between the ages of 14 and 48 years, did not have cervicitis, and were not pregnant. Informed consent was obtained, a prequestionnaire was completed, the IUD was placed in accordance with clinician preference, and a postquestionnaire was administered.

Results: Thirty-seven patients answered the question about expected pain. Two (5%) reported that their pain during IUD placement was none, 22 (59%) reported that pain was better than expected, 10 (27%) reported that pain was just as bad as expected, two (5%) reported pain was worse than expected, and one (3%) indicated that their pain during IUD placement was much worse than expected. Thirty-three patients received an intracervical or paracervical block, and five patients did not receive an intracervical or paracervical block; these groups reported visual analog pain scores of 35 ± 25 mm and 58 ± 14 mm, respectively (P = 0.22).

Conclusion: Approximately 8% of patients in our study reported worse or much worse than expected pain with IUD placement. Patients who received an intracervical or paracervical block reported less pain, but this difference was not statistically significant. Paracervical or intracervical blocks can decrease perceived pain with IUD insertion, increasing contraceptive options for those who are concerned about painful insertions; however larger studies are needed.