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Hum. Reprod. Advance Access published online on July 14, 2006
Human Reproduction, doi:10.1093/humrep/del276
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© The Author 2006. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Received March 29, 2006
Revised June 7, 2006
Accepted June 16, 2006

Article

Vaginoscopic versus conventional approaches to outpatient diagnostic hysteroscopy: a two-centre randomized prospective study

O. Garbin 1 *, R. Kutnahorsky 2, J.L. Göllner 2, and C. Vayssiere 3

1 Service de Gynécologie, SIHCUS-CMCO, Schiltigheim, France
2 Service de Gynécologie, CME Le Parc, Colmar, France
3 Service de Gynécologie, SIHCUS-CMCO, Schiltigheim

* To whom correspondence should be addressed.
O. Garbin, E-mail: olivier.garbin{at}sihcus.fr


  Abstract

BACKGROUND: To compare the tolerability and feasibility of the transvaginal and standard approaches in outpatient diagnostic hysteroscopy. METHODS: This randomized prospective trial was carried out in two centres to compare the transvaginal (n = 200) and conventional (n = 200) approaches during outpatient hysteroscopy. Patients were randomized by a computer-generated list. The main outcome measure was pain during the examination, measured on a visual analogue scale (VAS) graded from 0 to 10 (0 = lowest, 10 = highest). Secondary criteria were ease of instrument passage through the cervix, investigation quality and its duration. For data analysis, we used the chi-squared test or Fischer’s exact test for qualitative variables and the Mann-Whitney U-test for quantitative variables. RESULTS: Median VAS was rated at 0.5 for the vaginoscopic and 2 for the standard (P < 0.0001) approaches. The approaches did not differ significantly in investigation quality, procedure duration or ease of cervical passage (although the latter was more often easy transvaginally). CONCLUSIONS: The transvaginal approach is better tolerated than the conventional technique in outpatient diagnostic hysteroscopy.

Keywords: feasibility/outpatient hysteroscopy/tolerability/vaginoscopic approach.
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