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Vaginohysteroscopy, a patient-friendly technique for outpatient hysteroscopy: experience of the first 100 cases.

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 < or = 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.

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