Diagnostic minihysteroscopy with vaginoscopic approach: rationale and advantages

Diagnostic hysteroscopy still is considered an invasive and painful technique. In recent years, a new technique based on the employment of minihysteroscopes with fluid distention and vaginoscopic approach has been proposed in order to improve feasibility and reduce pain and side effects. Size reduction of the hysteroscope is of greatest importance for reducing pain and risk of vasovagal reaction. In conclusion, the best approach in terms of ease, reliability, acceptability, and safety to patients in whom intrauterine exploration is indicated should be simple diagnostic hysteroscopy using a small-diameter, rod lens hysteroscope with a single-flow diagnostic sheath, vaginoscopic approach, and fluid distention. In this way in about 90% of patients, a correct diagnosis and proper choice for eventual subsequent operative strategy can be obtained, without discomfort and risk.