Vaginoscopic versus conventional approaches to outpatient diagnostic hysteroscopy: a two-centre randomized prospective study

O Garbin, R Kutnahorsky, J L Göllner, C Vayssiere
Human Reproduction 2006, 21 (11): 2996-3000

BACKGROUND: To compare the tolerability and feasibility of the transvaginal and standard approaches in outpatient diagnostic hysteroscopy.

METHODS: This randomized prospective trial was carried out in two centres to compare the transvaginal (n = 200) and conventional (n = 200) approaches during outpatient hysteroscopy. Patients were randomized by a computer-generated list. The main outcome measure was pain during the examination, measured on a visual analogue scale (VAS) graded from 0 to 10 (0 = lowest, 10 = highest). Secondary criteria were ease of instrument passage through the cervix, investigation quality and its duration. For data analysis, we used the chi-squared test or Fischer's exact test for qualitative variables and the Mann-Whitney U-test for quantitative variables.

RESULTS: Median VAS was rated at 0.5 for the vaginoscopic and 2 for the standard (P < 0.0001) approaches. The approaches did not differ significantly in investigation quality, procedure duration or ease of cervical passage (although the latter was more often easy transvaginally).

CONCLUSIONS: The transvaginal approach is better tolerated than the conventional technique in outpatient diagnostic hysteroscopy.

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