Vaginoscopy Against Standard Treatment: a randomised controlled trial

Smith, P; Kolhe, Shilpa; O’Connor, Stephen S.; Clark, T. Justin

doi:10.1111/1471-0528.15665

Cited by 68 publications

(69 citation statements)

References 17 publications

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“…After the initial title and abstract screening, the full‐texts of 100 potentially eligible citations were retrieved for evaluation. Finally, 39 RCT (Women n = 3964) were included in the present systematic review and NMA. Figure shows the PRISMA flowchart.…”

Section: Resultsmentioning

confidence: 99%

Evaluation and ranking of different interventions for pain relief during outpatient hysteroscopy: A systematic review and network meta‐analysis

Ghamry

Samy

Abdelhakim

et al. 2020

J of Obstet and Gynaecol

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Section: Resultsmentioning

confidence: 99%

Evaluation and ranking of different interventions for pain relief during outpatient hysteroscopy: A systematic review and network meta‐analysis

Ghamry

Samy

Abdelhakim

et al. 2020

J of Obstet and Gynaecol

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“…In cases where the cervix is unable to be visualized with a speculum, use of o ce based vaginoscopy may provide a viable alternative for some procedures. 6 Vaginoscopy is typically performed with a rigid or exible hysteroscope, allowing visualization of the cervix and vagina, as well as the uterine cavity in many cases. Endometrial sampling via the hysteroscope is also feasible.…”

Section: Discussionmentioning

confidence: 99%

Lateral Decubitus Position to Facilitate Pelvic Examination of the Patient with Severe Obesity

Breitkopf

2020

Preprint

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Background: Patients with elevated BMI pose a number of challenges for the gynecologist. Pelvic examination may be more difficult due to adiposity in the perineum and labia, increasing the distance between the vulva and cervix. The objective of the current work was to describe use of the lateral decubitus position to improve visualization of the cervix in women with severe obesity. Methods: From 7/1/2010 until 1/31/2020, all records of patients with obesity and unsuccessful cervical visualization during pelvic exam in the dorsal lithotomy position in the author’s clinical practice were reviewed after obtaining Mayo Clinic Institutional Review Board approval. For the lateral decubitus position, the patient was asked to lie on her side on the exam table, facing away from the examiner with knees bent. An assistant elevated the upper bent leg 45 degrees from horizontal, exposing the perineum. A vaginal speculum was then placed in the vagina with the posterior blade toward the anus. The speculum was opened gently as would be done with examination in dorsal lithotomy position until the cervix was visualized.Results: Eleven patients with severe obesity in the gynecologic practice of the author with prior unsuccessful cervical visualization in dorsal lithotomy position were examined in the lateral decubitus position. In all but one case the cervix was successfully visualized in the lateral decubitus position and all intended intrauterine procedures were successfully performed. Conclusions: The use of the lateral decubitus position appears to improve visualization of the cervix in the outpatient setting among women with severe obesity. Consideration should be given to use of the lateral decubitus position when the cervix cannot be visualized in the dorsal lithotomy position.Trial registration: not applicable

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“…The availability of miniature hysteroscopes has facilitated this development. A randomised controlled multicentre trial in the UK concluded that vaginoscopy is quicker to perform, less painful, and more successful than standard hysteroscopy and therefore should be regarded as the technique of choice for outpatient hysteroscopy [7,8].…”

Section: Vaginoscopymentioning

confidence: 99%

Advances in Outpatient Hysteroscopy

Ajmi¹

2022

Ultimate Guide to Outpatient Care

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Hysteroscopy is a gynaecological procedure that has developed into an important tool to identify endometrial abnormality. It offers direct examination of the uterine cavity and tubal ostia and offers the option of performing targeted biopsy of suspected lesions that can be missed by blind procedures. In a large number of cases, the intrauterine lesions can be diagnosed and treated at the same setting as one step approach (“see and treat”). For example, endometrial polyps can be identified and removed; intrauterine adhesions may be divided in the office owing to the practicability of operative saline hysteroscopy, vaginoscopic approach and the convenience of miniature hysteroscopes. There is decent evidence that hysteroscopy in the outpatient clinic setting is preferred by the patients, associated with low risk of complications, quicker recovery time and reduced cost. Technological advances have led to development of high definition miniature hysteroscopes without negotiating optical performance, and hence making hysteroscopy an ingenuous, safe and trusted office procedure. Recent advances such as bipolar electrosurgery, endometrial ablation devices, morcellators and tissue retrieval system has transformed the surgical technique. This modernization of hysteroscopy completely revolutionised the approach to the management of intrauterine pathologies, moving from a blind procedure under general anaesthesia to directly visualised procedure under no or local anaesthesia, offering diagnostic as well as therapeutic procedures that should be at the disposal of every modern gynaecologist.

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Vaginoscopy Against Standard Treatment: a randomised controlled trial

Cited by 68 publications

References 17 publications

Evaluation and ranking of different interventions for pain relief during outpatient hysteroscopy: A systematic review and network meta‐analysis

Evaluation and ranking of different interventions for pain relief during outpatient hysteroscopy: A systematic review and network meta‐analysis

Lateral Decubitus Position to Facilitate Pelvic Examination of the Patient with Severe Obesity

Advances in Outpatient Hysteroscopy

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