Reliability, feasibility, and safety of minihysteroscopy with a vaginoscopic approach: experience with 6,000 cases.
OBJECTIVE
To assess the reliability, feasibility, and safety of lens-based minihysteroscopy.


METHODS
Retrospective comparative study.


METHODS
Academic research environment.


METHODS
Women with different indications for hysteroscopy.


METHODS
Six thousand seventeen outpatient diagnostic hysteroscopies with a minihysteroscope (2.7-mm outer diameter [OD] telescope with 3.5-mm OD single-flow diagnostic sheath) and 4,204 with traditional hysteroscope (4-mm OD telescope with 5-mm OD single-flow diagnostic sheath). All hysteroscopies were performed using a vaginoscopic approach and saline to distend the uterus.


METHODS
Rate of successful introduction of the hysteroscope, rate of satisfactory examinations, pain intensity experienced using an arbitrary pain scale (0 = no pain; 1 = low pain; 2 = moderate pain; 3 = severe pain), and number of side effects and complications.


RESULTS
In the minihysteroscopy, group rates of successful introduction and satisfactory examinations were significantly higher than in the traditional hysteroscope group (99.52% vs.72.53% and 98.53% vs. 92.33%, respectively), while pain and vagal reactions were significantly lower (0.10 +/- 0.34 vs.1.09 +/- 0.53 and 2.25% vs.17.12%, respectively).


CONCLUSIONS
Hysteroscopy with lens-based minihysteroscopes was easier, less painful, more reliable, and safer than with 5-mm hysteroscopes. Minihysteroscopy with a vaginoscopic approach is a very well tolerated, effective, and safe outpatient procedure.
Cicinelli
Ettore
E
First Department of Obstetrics and Gynecology, University of Bari, Bari, Italy. cicinelli@gynecology1.uniba.it
Parisi
Carlo
C
Galantino
Pietro
P
Pinto
Vincenzo
V
Barba
Bruno
B
Schonauer
Sergio
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D020702:Hysteroscopes; D015907:Hysteroscopy / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D010045:Outpatients; D017699:Pelvic Pain / Q000473:pathology; D012189:Retrospective Studies; D014591:Uterine Diseases / Q000175:diagnosis; D014599:Uterus / Q000601:surgery