Comparison between vaginoscopy and traditional technique of hysteroscopy under local anesthesia for operative approach

Objective: To compare vaginoscopy with traditional technique of hysteroscopy combined with local anesthesia for surgical procedures in terms of patient compliance and ease of procedure.
Material and Method: A total of 98 women who were scheduled for operative hysteroscopy were divided into two groups: Group 1 (vaginoscopy), Group 2 (traditional technique with local anesthesia). Patient compliance was assessed by using a Visual Analog Scale (VAS) at five different time points as follows: before placement of speculum, phase 1 (baseline pain perception); after placement of the speculum, phase 2; after grasping with tenaculum, phase 3; during hysteroscopy, phase 4; and 5 min after the procedure, phase 5.VAS-4 reflected the compliance of patients. We determined the ease of the procedure by employing Likert-type scale to clinicians.
Results: VAS-2 scores were statistically higher in Group 2 than Group 1 (P=0.001). There were no significant differences between VAS-1, VAS-3 and VAS-5 scores. VAS-4 scores were statistically higher in Group 1 than Group 2 (P=0.001) Likert-type scale scores were statistically higher in Group 2 (P<0.001), but the procedure time was longer in Group 1 than Group 2 (P=0.001).
Conclusion: Usage of tenaculum and speculum decreases the compliance of the patient although they help to facilitate the procedure. However based on our study, we suggest that traditional technique combined with local anesthesia may be better than vaginoscopy for operative procedures in terms of