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BJOG. 2019 Jun;126(7):891-899. doi: 10.1111/1471-0528.15665. Epub 2019 Mar 20.

Vaginoscopy Against Standard Treatment: a randomised controlled trial.

Author information

1
Institute of Metabolism and Systems Research, College of Medical & Dental Sciences, University of Birmingham, Birmingham, UK.
2
Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK.
3
Royal Derby Hospital, Derby, UK.

Abstract

OBJECTIVE:

To evaluate whether vaginoscopy or standard hysteroscopy was more successful in the outpatient setting.

DESIGN:

Randomised controlled multicentre trial.

SETTING:

Outpatient hysteroscopy clinics at two UK hospitals.

POPULATION:

1597 women aged 16 or older undergoing an outpatient hysteroscopy.

METHODS:

Women were allocated to vaginoscopy or standard hysteroscopy using third party randomisation stratified by menopausal status with no blinding of participants or clinicians.

MAIN OUTCOME MEASURES:

The primary outcome was 'success', a composite endpoint defined as: a complete procedure, no complications, a level of pain acceptable to the patient, and no sign of genitourinary tract infection 2 weeks after the procedure.

RESULTS:

Vaginoscopy was significantly more successful than standard hysteroscopy [647/726 (89%) versus 621/734 (85%), respectively; relative risk (RR) 1.05, 95% CI 1.01-1.10; P = 0.01]. The median time taken to complete vaginoscopy was 2 minutes compared with 3 minutes for standard hysteroscopy (P < 0.001). The mean pain score was 42.7 for vaginoscopy, which was significantly less than standard hysteroscopy 46.4 (P = 0.02). Operative complications occurred in five women receiving vaginoscopy and 19 women receiving standard hysteroscopy (RR 0.26, 95% CI 0.10-0.69).

CONCLUSIONS:

Vaginoscopy is quicker to perform, less painful, and more successful than standard hysteroscopy and therefore should be considered the technique of choice for outpatient hysteroscopy.

TWEETABLE ABSTRACT:

Vaginoscopy is quicker to perform, less painful, and more successful than standard hysteroscopy.

KEYWORDS:

Ambulatory hysteroscopy; hysteroscopy; office hysteroscopy; outpatient hysteroscopy; vaginoscopy

Comment in

PMID:
30801889
DOI:
10.1111/1471-0528.15665
[Indexed for MEDLINE]

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