title: Randomized study of vaginoscopy and H Pipelle vs traditional hysteroscopy and standard Pipelle.
abstract: OBJECTIVE
  To compare the use of vaginoscopic vs traditional hysteroscopy in evaluation of the endometrial cavity.
  
  
  METHODS
  Prospective, randomized, single blinded, clinical trial (Canadian Task Force classification I).
  
  
  METHODS
  University-affiliated hospital in Hong Kong.
  
  
  METHODS
  Ninety women scheduled to undergo diagnostic hysteroscopy without anesthesia.
  
  
  METHODS
  Women were randomized to undergo either vaginoscopic hysteroscopy using the H Pipelle for endometrial sampling (n = 45) or traditional hysteroscopy using the standard Pipelle (n = 45). Both procedures were performed without anesthesia and using a rigid 4.5-mm hysteroscope. Main outcome measures analyzed were pain scores using a 10-point visual analog scale during hysteroscopy, endometrial biopsy, and overall pain score of the procedure, success and duration of each procedure, and adequacy of the endometrial sample obtained.
  
  
  RESULTS
  The success rates for vaginoscopic and traditional hysteroscopy were 93.33% and 100%, respectively (p = .24). There was no significant difference in the mean pain score and procedure duration between the 2 hysteroscopic approaches. Endometrial sampling using the H Pipelle was significantly quicker by about 45 seconds compared with use of the standard Pipelle (mean [SD] duration, 1.46 [0.72] min vs 2.20 [1.19] min, respectively; p = .001), with similar biopsy adequacy. Most women (95.5% in both approaches) found the procedure acceptable. There were no intraoperative or postoperative complications.
  
  
  CONCLUSIONS
  Vaginoscopic and traditional hysteroscopic approaches are similar in safety, feasibility, and associated pain. Although the time needed to obtain an endometrial sample using the H Pipelle was quicker than with the standard Pipelle, there is no difference in overall procedure duration.
authors.affiliation: Department of Obstetrics and Gynecology, Queen Mary Hospital, University of Hong Kong, Hong Kong, China. ngusiewf@hku.hk
authors.forename: Siew-Fei
authors.initials: SF
authors.lastname: Ngu
authors.forename: Vincent Y T
authors.initials: VY
authors.lastname: Cheung
authors.forename: Ting-Chung
authors.initials: TC
authors.lastname: Pun
mesh_terms: D001706:Biopsy; D004717:Endometrium / Q000473:pathology*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D020702:Hysteroscopes; D015907:Hysteroscopy / Q000295:instrumentation / Q000379:methods*; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis / Q000209:etiology; D010147:Pain Measurement; D016037:Single-Blind Method