Khoiwal Kavita, Zaman Rabia, Bahurupi Yogesh, Gaurav Amrita, Chaturvedi Jaya
Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Rishikesh, India.
Department of Community and Family Medicine, All India Institute of Medical Sciences, Rishikesh, India.
Int J Gynaecol Obstet. 2024 Jan;164(1):47-55. doi: 10.1002/ijgo.14902. Epub 2023 Jun 12.
Outpatient hysteroscopy is a safe, feasible, and optimum procedure for the diagnosis and management of intrauterine pathologies.
To determine the best approach of outpatient hysteroscopy (vaginoscopic vs traditional) in terms of pain, duration of procedure, feasibility, safety, and acceptability.
PubMed, Embase, Google Scholar, and Scopus were searched from January 2000 to October 2021. No filters or restrictions were applied.
Randomized controlled trials comparing vaginoscopic hysteroscopy with traditional hysteroscopy in an outpatient setting.
Two authors independently performed a comprehensive literature search and collected and extracted data. The summary effect estimate was determined using both fixed effects and random-effects models.
Seven studies with 2723 patients (vaginoscopic [n = 1378] and traditional hysteroscopy [n = 1345]) were included. Vaginoscopic hysteroscopy was associated with a significant reduction in intraprocedural pain (standardized mean difference, -0.05 [95% confidence interval (CI), -0.33 to -0.23], I = 0%), procedural time (standardized mean difference, -0.45 [95% CI, -0.76 to -0.14], I = 82%), and fewer side effects (relative risk, 0.37 [95% CI, 0.15-0.91], I = 0%). The procedure failure rate was similar in both approaches (relative risk, 0.97 [95% CI, 0.71-1.32], I = 43%). Complications were mostly documented with traditional hysteroscopy.
Vaginoscopic hysteroscopy reduces the pain and duration compared with traditional hysteroscopy.
门诊宫腔镜检查是诊断和处理子宫内病变的一种安全、可行且最佳的方法。
从疼痛、手术时长、可行性、安全性和可接受性方面确定门诊宫腔镜检查的最佳方法（阴道镜宫腔镜检查与传统宫腔镜检查）。
检索了2000年1月至2021年10月期间的PubMed、Embase、谷歌学术和Scopus。未应用任何筛选器或限制条件。
在门诊环境中比较阴道镜宫腔镜检查与传统宫腔镜检查的随机对照试验。
两位作者独立进行了全面的文献检索，并收集和提取数据。使用固定效应模型和随机效应模型确定汇总效应估计值。
纳入了7项研究，共2723例患者（阴道镜宫腔镜检查组[n = 1378]和传统宫腔镜检查组[n = 1345]）。阴道镜宫腔镜检查在术中疼痛方面显著减轻（标准化均数差值，-0.05[95%置信区间(CI)，-0.33至-0.23]，I² = 0%），手术时间缩短（标准化均数差值，-0.45[95%CI，-0.76至-0.14]，I² = 82%），且副作用更少（相对危险度，0.37[95%CI，0.15 - 0.91]，I² = 0%）。两种方法的手术失败率相似（相对危险度，0.97[95%CI，0.71 - 1.32]，I² = 43%）。并发症大多记录于传统宫腔镜检查。
与传统宫腔镜检查相比，阴道镜宫腔镜检查可减轻疼痛并缩短时长。
