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Comparative Evaluation of Vaginoscopy vs Traditional Hysteroscopy
Table 4: Intraoperative complications in each group of hysteroscope has eliminated the use of any premedication
Group A Group B rendering the procedure faster and less associated complication
(Traditional) (Vaginoscopic) rate. Narrower hysteroscopes reduce pain while giving a satisfactory
Complication N = 44 N = 42 view of the endometrial cavity with lower failure rates.
1 No complication 43 97.72% 41 97.61%
2 Anesthesia-related orcId
a. Apnea — — — — Rashmi Kumari https://orcid.org/0000-0001-7844-374X
b. Tachycardia 1 2.27% — —
c. Bradycardia — — 1 2.38%
3 Distention media references
a. Complication 1. Clark TJ, Voit D, Gupta JK, et al. Accuracy of hysteroscopy in the diagnosis
b. CO embolism — — — — of endometrial cancer and hyperplasia: a sytematic quantitative review.
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4 Fluid overload — — — — JAMA 2002;288(13):1610–1621. DOI: 10.1001/jama.288.13.1610.
Uterine perforation — — — — 2. Busquets M, Lemus M. Factibilidad de histeroscopia panorámica
con CO . Experiencia clínica: 923 casos [Practicability of panoramic
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Table 5: Causes of failure Ginecol. 1993;58(2):113-8. Spanish. PMID: 8209037.
Group A Group B 3. Clark TJ, Gupta JK. Handbook of outpatient hysteroscope. A complete
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1 Cervical stenosis 2 4% 5 10% 4. Mukhopadhyay SR, Ashis K. Correlation between diagnostic
2 Cervix high-up 2 4% 1 2% hysteroscopy and its histopathological examination in the evaluation
3 Acutely anteverted or of abnormal uterine bleeding. Indian J Prev Soc Med 2014;45(1–2):
retroverted uterus 1 2% 2 4% 62–65.
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3 and 5 minutes. There is a significant difference in procedure time 6. Guida M, Di Spiezio Sardo A, Acunzo G, et al. Vaginoscopic versus
p <0.05 during diagnostic hysteroscopy in both the procedures. traditional office hysteroscopy: a randomised controlled study. Hum
Reprod 2006;21(12):3253–3257. DOI: 10.1093/humrep/del298. PMID:
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significantly shorter with “no-touch” hysteroscopy. A study goes randomized controlled trial to evaluate factors influencing the
on to conclude that the traditional approach should only be used success rate of office diagnostic hysteroscopy. Human Reprod
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anticipated. 17 8. Cooper N, Smith P, Khan K, et al. Vaginoscopic approach to outpatient
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Only one patient (2.27%) had experienced tachycardia during 9. Bettocchi S, Nappi L, Ceci O, et al. What does “diagnostic hysteroscopy”
traditional hysteroscopy. While one (2.38%) had bradycardia mean today? The role of new techniques. Curr Opin Obstret Gynecol
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procedure are relatively rare (Table 4). 10. Bettocchi S, Nappi L, Ceci O, et al. Office hysteroscopy. Obstret Gynecol
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procedures between the vaginoscopic and traditional approaches 11. Sagiv R, Sadan O, Boaz M, et al. A new approach to office hysteroscopy
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hysteroscopy is cervical stenosis in five patients (Table 5). In controlled trial. Obstet Gynecol 2006;108(2):387–392. DOI: 10.1097/01.
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stenosis in two patients (4%) and cervix high-up in two patients hysteroscopies. Obstret Gynecol 1996;88(1):87-92. DOI: 10.1016/0029-
(4%), followed by acutely anteverted or retroverted uterus (2%) 7844(96)00108-1.
and bleeding (2%). 13. Cicinelli E. Hysteroscopy without anaesthesia: review of recent
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