The Office Vaginoscopic Hysteroscopy in Management of Virginal Women with Recurrent Abnormal Uterine Bleeding

Introduction: Abnormal uterine bleeding (AUB) is the most common reason to visit gynecology outpatient clinic. Virginal women are a challenge for gynecologist in management of AUB. The office vaginoscopic hysteroscopy is an ideal selection. The usefulness and feasibility of no touch hysteroscopy in virginal women is rarely reported. Objectives: The feasibility of vaginoscopic hysteroscopy for management of virginal women with abnormal uterine bleeding AUB.

Materials and methods: Patients: A prospective observational study of 36 virginal women with AUB seen at the Kang Ning Hospital during a 10 months period, from 1st Jan to 31st Oct 2018 was included. Methods: Rigid hysteroscopy, 4mm out diameter (OD) was used after the initial clinical evaluation and transabdominal sonography.

Result: A total of 36 consecutive women, aged 16 to 52 (mean 31) with AUB was included. The hysteroscopy was successful in 31 out of 36 (86%), while incomplete view 4 (11%). One failed examination (3%) was excluded. A total of 35 women were included for study. Thirteen endometrial polyps (37%) and 2 submucosal leiomyomas (6%) were found. Total operation time: mean time 3 m 29 s± 1 m16 s (range 1 m 54 s- 11 m 31 s). Patients rated pain score: 3 ±1.6 (range 1-8). There was no hymeneal injury, only one vasovagal attack occurred. Thirteen women underwent see and treat endometrial biopsy no malignancy was found. Subsequent two submucosal myomectomy with hymenoplasty were performed.

Conclusion: The office vaginoscopic hysteroscopy is safe and feasible for assessment of virginal women with AUB.

Keywords: Virginal women; Vaginoscopic hysteroscopy; Abnormal uterine bleeding; Endometrial polyp; Submucosal leiomyomas; Hymenoplasty.