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- Title
Vaginoscopy Against Standard Treatment: a randomised controlled trial.
- Authors
Smith, PP; Kolhe, S; O'Connor, S; Clark, TJ; Smith, P P; Clark, T J
- Abstract
<bold>Objective: </bold>To evaluate whether vaginoscopy or standard hysteroscopy was more successful in the outpatient setting.<bold>Design: </bold>Randomised controlled multicentre trial.<bold>Setting: </bold>Outpatient hysteroscopy clinics at two UK hospitals.<bold>Population: </bold>1597 women aged 16 or older undergoing an outpatient hysteroscopy.<bold>Methods: </bold>Women were allocated to vaginoscopy or standard hysteroscopy using third party randomisation stratified by menopausal status with no blinding of participants or clinicians.<bold>Main Outcome Measures: </bold>The primary outcome was 'success', a composite endpoint defined as: a complete procedure, no complications, a level of pain acceptable to the patient, and no sign of genitourinary tract infection 2 weeks after the procedure.<bold>Results: </bold>Vaginoscopy was significantly more successful than standard hysteroscopy [647/726 (89%) versus 621/734 (85%), respectively; relative risk (RR) 1.05, 95% CI 1.01-1.10; P = 0.01]. The median time taken to complete vaginoscopy was 2 minutes compared with 3 minutes for standard hysteroscopy (P < 0.001). The mean pain score was 42.7 for vaginoscopy, which was significantly less than standard hysteroscopy 46.4 (P = 0.02). Operative complications occurred in five women receiving vaginoscopy and 19 women receiving standard hysteroscopy (RR 0.26, 95% CI 0.10-0.69).<bold>Conclusions: </bold>Vaginoscopy is quicker to perform, less painful, and more successful than standard hysteroscopy and therefore should be considered the technique of choice for outpatient hysteroscopy.<bold>Tweetable Abstract: </bold>Vaginoscopy is quicker to perform, less painful, and more successful than standard hysteroscopy.
- Subjects
UNITED Kingdom; THERAPEUTICS; HYSTEROSCOPY; DISEASE complications; PAIN; OUTPATIENT medical care; CERVIX uteri diseases; COMPARATIVE studies; RESEARCH methodology; MEDICAL cooperation; PATIENT satisfaction; RESEARCH; VAGINA; EVALUATION research; PAIN measurement; RANDOMIZED controlled trials
- Publication
BJOG: An International Journal of Obstetrics & Gynaecology, 2019, Vol 126, Issue 7, p891
- ISSN
1470-0328
- Publication type
journal article
- DOI
10.1111/1471-0528.15665