Objective: To evaluate the feasibility and tolerability of the vaginoscopic approach for office hysteroscopy.
Design: Prospective observational study.
Setting: Tertiary care hospital.
Subjects: Unselected, consecutive 100 patients scheduled for diagnostic hysteroscopy.
Intervention: Hysteroscopy with a vaginoscopic approach using a 5-mm rigid hysteroscope with
single inflow channel, and normal saline for distension.
Outcome Measures: Successful hysteroscopy by the vaginoscopic approach; operative time; and
degree of pain experienced.
Results: The vaginoscopic technique was successful in 79% of the patients. The median operative
time was 120 seconds in successful cases and 360 seconds in those in which the vaginoscopic approach
was unsuccessful and had to be performed by the conventional technique with or without
dilatation, the difference being statistically significant (P < 0.001). The procedure took ≤2 minutes
in 91.1% (72/79) of the successful cases. No pain or mild pain was experienced by 97.5% (77/79) of
patients in whom vaginohysteroscopy was successful.
Conclusion: Hysteroscopy with the vaginoscopic approach is the ideal method for outpatient hysteroscopy.
It is feasible, quick, and very well tolerated, obviating the need for any analgesia or local
anesthesia.
