Application of ‘no‐touch’ hysteroscopy (vaginoscopy) for the treatment of abnormal uterine bleeding in adolescence

Abstract

Aim: This article retrospectively analyzed the efficacy and safety of vaginoscopy in the treatment of adolescent abnormal uterine bleeding (AUB) in 204 cases of AUB. Method: From patients with intact hymen who were admitted to our hospital due to AUB received vaginoscopy, and vaginoscopy did not damage the hymen. In this study, 4.5 mm and 6.5 mm hysteroscopy were used with a pumping fluid pressure of 100-120 mm Hg and a flow rate of 400 mL/min. All 204 vaginoscopy was successfully completed in intravenous anesthesia. Results: Postoperative pathological examination confirmed that of the 204 patients, 53 patients had simple hyperplasia. There were 53 cases of polyps, 50 cases of endometrial gland hyperplasia and disordered arrangement, 35 cases of proliferative phase endometrium, five cases of bleeding phase endometrium, partial glandular secretion, three cases of complex hyperplasia and one case of decidua like change. Follow-up data from 64 patients showed that 34 patients were effective after treatment. Stepwise logistic regression analysis suggested that endometrial thickness was associated with treatment outcome (HR, 0.875, 95% CI, 0.786-0.974, P = 0.014). There was no significant difference in drug use between patients with effective and ineffective treatment. Conclusion: 'No-touch' vaginoscopy is feasible for the diagnosis and treatment of adolescent AUB without destroying the intact hymen.

Diagnostic discrepancy between colposcopy and vaginoscopy: A case report

“…After a randomized controlled trial, Smith et al [ 8 ] found vaginoscopy to be quicker to perform, less painful to patients, and more successful than standard hysteroscopy. Vaginoscopy, a “no-touch” approach, can be used not only to perform endometrial biopsy and remove foreign bodies in the vagina but also to meet the hopes of patients and their families of not damaging the hymen and reducing pain[ 9 ].…”

Effect of Tiaojingzhixue Fang on the expression of sex hormone and endometrial tissue mRNA in perimenopausal patients with abnormal uterine bleeding

“…Tuckahoe has the effect of improving water permeability, invigorating the spleen and calming heart. Scutellaria charcoal has the effects of clearing heat, dampness, relieving fire and detoxifying (23). Perimenopausal AUB patients are often accompanied by varying degrees of anemia, so this prescription can repair the patient's uterus and replenish blood and qi.…”

Vaginoscopy

“…It is recommended to adopt this painless, non-traumatic and innovative technique [2]. This technique is also used for women with intact hymen and adolescent girls with abnormal vaginal discharge and abnormal uterine bleeding without damaging the intact hymen [3,4]. This no-touch technique is more acceptable to patients, and they are more comfortable getting this procedure done in an office setting.…”