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

To compare the tolerability and feasibility of the transvaginal and standard approaches in outpatient diagnostic hysteroscopy.

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.

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).

The transvaginal approach is better tolerated than the conventional technique in outpatient diagnostic hysteroscopy.