This trial sought to determine if ‘Slow’ and ‘cough’ techniques for tenaculum placement resulted in less pain for patients.

66 participants were randomized to tenaculum placement via the ‘slow’ method versus the ‘cough’ method. The result was pain at the time of tenaculum placement measured on a 100 mm visual analog scale. Other outcomes included pain with insertion and provider satisfaction with tenaculum grasp. Pain scores were analyzed with the Wilcoxon rank-sum test.

66 women were enrolled, 33 randomized to each group. Both of the groups were comparable with respect to demographics. The primary outcome of pain with tenaculum placement showed a median pain score of 44 with slow placement and 32 with cough placement. No significant difference was observed in pain scores between methods of tenaculum placement. There was no significant difference in overall pain scores. Provider satisfaction was not associated with one method of placement. Pre-procedure anxiety was significantly associated with pain.

The study concluded that done of the two methods were superior for pain reduction or provider satisfaction. Pain with tenaculum use is significantly associated with anxiety.