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Vaginal Lesions Diagnosed and Treated with Hysteroscopy

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Abstract

Vaginal lesions represent an unusual, often underestimated, cause of genital complaints. The vaginoscopic approach for hysteroscopy offers a detailed endoscopic evaluation of the vaginal canal before accessing the uterine cavity since the vaginal walls, fornices, and esocervix can be easily and accurately examined through the magnification of the images on the monitor. This approach has contributed to the development and widespread use of hysteroscopy in an office-based setting, reducing patient discomfort, and suitable for use among women who have not been sexually active or have severe vaginal atrophy or stenosis. The recent technologic advancements, with the use of miniaturized mechanical instruments and the introduction of a versatile bipolar electrosurgery system dedicated to hysteroscopy, have made possible not only diagnosing but also treating uterine, cervical, and vaginal lesions in the office setting. Vaginoscopy shouldn’t be only an easier way to get into the cervical canal, but also an important tool in the hands of the gynecologist to diagnose and treat vaginal lesions, which required more invasive and traumatic approaches.

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References

  1. Cooper NAM, Smith P, Khan KS, Clark TJ. Vaginoscopic approach to outpatient hysteroscopy: a systematic review of the effect on pain. BJOG. 2010;117(5):532–9.

    Article  CAS  PubMed  Google Scholar 

  2. Di Spiezio Sardo A, Bettocchi S, Spinelli M, Guida M, Nappi L, Angioni S, et al. Review of new office-based hysteroscopic procedures 2003–2009. J Minim Invasive Gynecol. 2010;17(4):436–48.

    Article  PubMed  Google Scholar 

  3. Sagiv R, Sadan O, Boaz M, Dishi M, Schechter E, Golan A. A new approach to office hysteroscopy compared with traditional hysteroscopy: a randomized controlled trial. Obstet Gynecol. 2006;108(2):387–92.

    Article  PubMed  Google Scholar 

  4. Guida M, Di Spiezio Sardo A, Acunzo G, Sparice S, Bramante S, Piccoli R, et al. Vaginoscopic versus traditional office hysteroscopy: a randomized controlled study. Hum Reprod. 2006;21(12):3253–7.

    Article  CAS  PubMed  Google Scholar 

  5. Nappi C, Di Spiezio Sardo A. Rare and difficult-to-interpret hysteroscopic findings. In: Nappi C, Di Spiezio Sardo A, editors. State-of-the-art hysteroscopic approaches to pathologies of the genital tract. Tuttlingen: Endo-Press; 2014. p. 236–49.

    Google Scholar 

  6. Cooper NA, Smith P, Khan KS, Clark TJ. A systematic review of the effect of the distension medium on pain during outpatient hysteroscopy. Fertil Steril. 2011;95(1):264–71.

    Article  PubMed  Google Scholar 

  7. Morch ET. A new instrument for vaginoscopy and anoscopy. Am Surg. 1952;18(2):160–1.

    CAS  PubMed  Google Scholar 

  8. Capraro VJ. Gynecologic examination in children and adolescents. Pediatr Clin N Am. 1972;19(3):511–28.

    Article  CAS  Google Scholar 

  9. Bettocchi S, Selvaggi L. A vaginoscopic approach to reduce the pain of office hysteroscopy. J Am Assoc Gynecol Laparosc. 1997;4(2):255–8.

    Article  CAS  PubMed  Google Scholar 

  10. Garbin O, Kutnahorsky R, Gollner JL, Vayssiere C. Vaginoscopic versus conventional approaches to outpatient diagnostic hysteroscopy: a two-centers randomized prospective study. Hum Reprod. 2006;21(11):2996–3000.

    Article  CAS  PubMed  Google Scholar 

  11. Bettocchi S, Ceci O, Di Venere R, Pansini MV, Pellegrino A, Marello F, et al. Advanced operative office hysteroscopy without anaesthesia: analysis of 501 cases treated with a 5 Fr. bipolar electrode. Hum Reprod. 2002;17(9):2435–8.

    Article  CAS  PubMed  Google Scholar 

  12. Sharma M, Taylor A, Di Spiezio Sardo A, Buck L, Mastrogamvrakis G, Kosmas I, et al. Outpatient hysteroscopy: traditional versus the ‘no-touch’ technique. BJOG. 2005;112(7):963–7.

    Article  CAS  PubMed  Google Scholar 

  13. Paschopoulos M, Paraskevaidis E, Stefanidis K, Kofinas G, Lolis D. Vaginoscopic approach to outpatient hysteroscopy. J Am Assoc Gynecol Laparosc. 1997;4(4):465–7.

    Article  CAS  PubMed  Google Scholar 

  14. Di Spiezio Sardo A, Guida M, Pellicano M, Nappi C, Bettocchi S. New technique to perform hysteroscopy in “women with an intact hymen” is really just the vaginoscopic approach (no-touch technique). J Minim Invasive Gynecol. 2006;13(5):489–90.

    Article  PubMed  Google Scholar 

  15. Di Spiezio Sardo A, Calagna G, Di Carlo C. Tips and tricks in office hysteroscopy. Gynecol Minim Invasive Ther. 2015;4(1):3–7.

    Article  Google Scholar 

  16. Guida M, Di Spiezio Sardo A, Mignogna C, Bettocchi S, Nappi C. Vaginal fibro-epithelial polyp as cause of postmenopausal bleeding: office hysteroscopic treatment. Gynecol Surg. 2008;5(1):69–70.

    Article  Google Scholar 

  17. Di Spiezio Sardo A, Di Carlo C, Spinelli ML, Zizolfi B, Sosa Fernandez LM, Nappi C. An earring incidentally diagnosed and removed through two-step vaginoscopy in a pubertal virgin with miliary tuberculosis. J Minim Invasive Gynecol. 2014;21(2):176–7.

    Article  PubMed  Google Scholar 

  18. Tsai EM, Chiang PH, Hsu SC, JH S, Lee JN. Hysteroscopic resection of vaginal septum in an adolescent virgin with obstructed hemivagina. Hum Reprod. 1998;13(6):1500–1.

    Article  CAS  PubMed  Google Scholar 

  19. Cicinelli E, Romano F, Didonna T, Schonauer LM, Galantino P, Di Naro E. Resectoscopic treatment of uterus didelphys with unilateral imperforate vagina complicated by hematocolpos and hematometra: case report. Fertil Steril. 1999;72(3):553–5.

    Article  CAS  PubMed  Google Scholar 

  20. Long C-Y, Juan Y-S, Liu C-M, CH W, Tsai EM. Concomitant resection of congenital vaginal septum during the tension-free vaginal tape procedure. Int Urogynecol J Pelvic Floor Dysfunct. 2005;16(4):311–2.

    Article  PubMed  Google Scholar 

  21. Di Spiezio Sardo A, Bettocchi S, Bramante S, Guida M, Bifulco G, Nappi C. Office vaginoscopic treatment of an isolated longitudinal vaginal septum: a case report. J Minim Invasive Gynecol. 2007;14(4):512–5.

    Article  PubMed  Google Scholar 

  22. Kim TE, Lee GH, Choi YM, Jee BC, SY K, Suh CS, et al. Hysteroscopic resection of the vaginal septum in uterus didelphys with obstructed hemivagina: a case report. J Korean Med Sci. 2007;22(4):766–9.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Cetinkaya SE, Kahraman K, Sonmezer M, Atabekoglu C. Hysteroscopic management of vaginal septum in a virginal patient with uterus didelphys and obstructed hemivagina. Fertil Steril. 2011;96(1):e16–8.

    Article  PubMed  Google Scholar 

  24. Nassif J, Al Chami A, Abu Musa A, Nassar AH, Kurdi A, Ghulmiyyah L. Vaginoscopic resection of vaginal septum. Surg Technol Int. 2012;22:173–6.

    PubMed  Google Scholar 

  25. Di Spiezio Sardo A, Di Iorio P, Guida M, Pellicano M, Bettocchi S, Nappi C. Vaginoscopy to identify vaginal endometriosis. J Minim Invasive Gynecol. 2009;16(2):128–9.

    Article  PubMed  Google Scholar 

  26. Darwish AM, Hassan ZZ, Attia AM, Abdelraheem SS, Ahmed YM. Biological effects of distension media in bipolar versus monopolar resectoscopic myomectomy: a randomized trial. J Obstet Gynaecol Res. 2010;36(4):810–7.

    Article  PubMed  Google Scholar 

  27. Smorgick N, Padua A, Lotan G, Halperin R, Pansky M. Diagnosis and treatment of pediatric vaginal and genital tract abnormalities by small diameter hysteroscope. J Pediatr Surg. 2009;44(8):1506–8.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Public Health, School of Medicine, University of Naples “Federico II”, Naples, Italy

    Brunella Zizolfi M.D., Carmine Nappi & Attilio Di Spiezio Sardo

  2. Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples “Federico II”, Naples, Italy

    Fabrizia Santangelo & Ursula Catena

Authors
  1. Brunella Zizolfi M.D.
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  2. Fabrizia Santangelo
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  3. Ursula Catena
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  4. Carmine Nappi
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  5. Attilio Di Spiezio Sardo
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Corresponding author

Correspondence to Brunella Zizolfi M.D. .

Editor information

Editors and Affiliations

  1. Department of Obstetrics and Gynaecology, Ospedale Vito Fazzi, Lecce, Italy

    Andrea Tinelli

  2. Hysteroscopy Unit, Gutenberg Institute, Malaga, Spain

    Luis Alonso Pacheco

  3. Hysteroscopy Unit, Hospital Del Mar, Barcelona, Spain

    Sergio Haimovich

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Zizolfi, B., Santangelo, F., Catena, U., Nappi, C., Di Spiezio Sardo, A. (2018). Vaginal Lesions Diagnosed and Treated with Hysteroscopy. In: Tinelli, A., Alonso Pacheco, L., Haimovich, S. (eds) Hysteroscopy. Springer, Cham. https://doi.org/10.1007/978-3-319-57559-9_56

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  • DOI: https://doi.org/10.1007/978-3-319-57559-9_56

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-57558-2

  • Online ISBN: 978-3-319-57559-9

  • eBook Packages: MedicineMedicine (R0)

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