Tien Chin-Tzu, Li Pei-Chen, Ding Dah-Ching
Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital; Buddhist Tzu Chi Medical Foundation; Tzu Chi University, Hualien, Taiwan, ROC.
Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan, ROC.
J Chin Med Assoc. 2021 May 1;84(5):536-539. doi: 10.1097/JCMA.0000000000000519.
Hysteroscopy is a traditional diagnostic method, whereas vaginoscopy is a more recent but proven approach. However, most physicians are unfamiliar with vaginoscopy. We aimed to compare the feasibility and tolerability between the two techniques to increase clinical awareness.
We retrospectively reviewed the data of 100 patients who underwent office hysteroscopy with either the standard approach or the vaginoscopic approach between May and July 2019. While the standard hysteroscopy group underwent speculum insertion and the cervix was grasped with forceps, the vaginoscopy group did not. The primary outcome was a successfully completed examination. Related outcomes were the pain score, complications, and absence of signs of infection at 1 week after completing the examination.
The success rates of vaginoscopy and standard hysteroscopy were comparable (95.5% vs 96.3%). The median time to complete a vaginoscopy (135 seconds) was significantly shorter than to complete a standard hysteroscopy (190 seconds, p = 0.02). The median pain score was 3 for vaginoscopy, which was significantly lower than that for standard hysteroscopy (5; p = 0.01). There were no differences in the surgical complication rate between vaginoscopy (n = 4) and standard hysteroscopy (n = 3) (relative risk = 0.81, 95% confidence interval = 0.11-6.00).
Vaginoscopy required a shorter time for the completion of the examination and involved lesser pain than the standard hysteroscopy. The success rates were comparable between the two techniques. Therefore, vaginoscopy is a good option for office hysteroscopic examinations.
宫腔镜检查是一种传统的诊断方法，而阴道镜检查是一种较新但已得到验证的方法。然而，大多数医生并不熟悉阴道镜检查。我们旨在比较这两种技术的可行性和耐受性，以提高临床认识。
我们回顾性分析了2019年5月至7月间采用标准方法或阴道镜方法进行门诊宫腔镜检查的100例患者的数据。标准宫腔镜检查组进行窥器插入并用钳子抓住宫颈，而阴道镜检查组则不进行这些操作。主要结局是检查成功完成。相关结局包括疼痛评分、并发症以及检查完成后1周无感染迹象。
阴道镜检查和标准宫腔镜检查的成功率相当（95.5%对96.3%）。完成阴道镜检查的中位时间（135秒）明显短于完成标准宫腔镜检查的时间（190秒，p = 0.02）。阴道镜检查的中位疼痛评分为3分，明显低于标准宫腔镜检查（5分；p = 0.01）。阴道镜检查组（n = 4）和标准宫腔镜检查组（n = 3）的手术并发症发生率无差异（相对危险度 = 0.81，95%置信区间 = 0.11 - 6.00）。
与标准宫腔镜检查相比，阴道镜检查完成检查所需时间更短，疼痛更小。两种技术的成功率相当。因此，阴道镜检查是门诊宫腔镜检查的一个好选择。
