Abstract
Background:
To present a case series of hysteroscopic procedures needed to be done in virgin patients with variable indications. To describe approaches that were used with encouraging tips and precautions.
Technique:
A prospective analysis for hysteroscopic procedures for 44 virgin patients (March 2022–March 2024). Sedation was used in all patients. Office or mini-operative hysteroscopy was used to diagnose and/or treat the pathology, including polypectomy, myomectomy, endometrial sampling, and foreign body extraction. Main outcome: managing all cases, whether by sampling or excision of the pathology, while preserving the hymen with variable approaches (bridging method).
Cases:
The age range was (12–58 years). Abnormal uterine bleeding was the main presentation in 40 cases (91%), vaginal foreign body causing discharge in two cases, and a prolapsed lump through the hymen in two cases. In 28 cases, office hysteroscopy was used, and mini-operative hysteroscopy in 14 cases, all via the vaginoscopic approach. Normal saline was used in all office hysteroscopy procedures, while 1.5% glycine was used in all mini-resectoscopic procedures requiring monopolar power. The hymen remained intact in all cases. No intra- or postoperative complications occurred. Two cases required a second setting hysteroscopy as per the large-sized lesion. Symptom relief was reported by all but three cases, for which reevaluation and follow-up were arranged.
Conclusions:
Hysteroscopic interventions in virgin patients can be undertaken safely and efficiently to manage variable pathologies. The procedure requires a confident hysteroscopist, a carefully selected patient, and thorough preoperative counseling.
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