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ORIGINAL RESEARCH
Comparative Evaluation of Vaginoscopic vs Traditional

Hysteroscopy

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Neena Gupta , Uruj Jahan , Anuradha Yadav , Rashmi Kumari 4
AbstrAct
Aim: A randomized case–control study was performed to compare the traditional using a speculum vs vaginoscopic hysteroscopy in terms of
pain score and procedure time.
Materials and methods: A total of 100 patients aged 20 to 60 years old, including nulliparous, multiparous, and postmenopausal, were
randomized in two groups: group A undergoing traditional hysteroscopy with speculum and vulselum (50 patients) and group B undergoing
“no-touch” vaginoscopic hysteroscopy.
Results: Vaginoscopy was significantly more successful than the traditional hysteroscopy. The total pain was calculated for each group, it was
significantly lower in the vaginoscopic technique (p = 0.026). The mean time was 5.71 for traditional hysteroscopy and 4.44 for vaginoscopic
hysteroscopy. The time taken to perform hysteroscopy was significantly shorter with vaginoscopic hysteroscopy. There was no difference in
failure rates.
Conclusion: The vaginoscopic approach is better tolerated, quicker to perform, less painful, and therefore, more successful than the traditional
hysteroscopy using the speculum. It should be preferred in an outpatient setting.
Keywords: Hysteroscopy, Outpatient, Pain score, Procedure time, Traditional, Vaginoscopic.
World Journal of Laparoscopic Surgery (2021): 10.5005/jp-journals-10033-1455

IntroductIon 1–4 Department of Obstetrics and Gynecology, GSVM Medical College,
Hysteroscopy word is derived from Latin word “haustera,” i.e., Kanpur, Uttar Pradesh, India
womb. In the present scenario, hysteroscopy has become the Corresponding Author: Rashmi Kumari, Department of Obstetrics
gold standard while evaluating the vagina, cervix, cervical canal, and Gynecology, GSVM Medical College, Kanpur, Uttar Pradesh, India,
and uterine cavity. It is the process of viewing and operating in Phone: +91 09076568314, e-mail: insh6142@gmail.com
the endometrial cavity from a transcervical approach, offering How to cite this article: Gupta N, Jahan U, Yadav A, et al. Comparative
the advantage of direct visualization of the uterine cavity while Evaluation of Vaginoscopic vs Traditional Hysteroscopy. World J Lap
giving the option of collecting histological biopsy samples Surg 2021;14(2):98–102.
under visual control. Ambulatory hysteroscopy is a safe, feasible, Source of support: Nil

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and accurate procedure for diagnosing intrauterine pathology Conflict of interest: None
and treating many intrauterine, endocervical problems. It can be
used for the evaluation of the uterine cavity in cases of abnormal
uterine bleeding (AUB), infertility, and recurrent pregnancy
loss. Diagnostic hysteroscopy was then performed using two AIms And objectIves
different techniques:
To compare vaginoscopic hysteroscopy and traditional hysteroscopy
• Traditional technique: A Sims speculum was inserted into the in terms of the following:
vagina to visualize the cervix, and a vulselum was then applied
to the anterior lip of uterine cervix to create countertraction to • Comparative evaluation of pain during an intraoperative period
facilitate the insertion of the hysteroscope. in both procedures.
• No-touch technique: Also known as vaginoscopy is an • An intraoperative complication in both studies (cervical lip
alternative technique where hysteroscope is first introduced tearing, bleeding, and uterine perforation)
into the introitus of the vagina and avoids the use of the • Evaluation of procedure time in both procedures.
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speculum and a tenaculum to grasp or steady the cervix. • Comparative evaluation of the success of the procedure in both
The vagina is then distended with the saline distention studies.
medium and hysteroscope directed toward the cervix, the • Evaluation of causes of the failure in both procedures.
cervical canal, and then into the uterine cavity. This study
tries to evaluate the role of hysteroscopy as a diagnostic mAterIAls And methods
tool in women with different gynecological problems and This randomized case–control study was carried out in the
compare the two approaches of hysteroscopy—traditional Obstetrics and Gynecology Department in the GSVM Medical
and vaginoscopic. College, Kanpur, during a study period from December 2017 to

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