Application of ‘no‐touch’ hysteroscopy (vaginoscopy) for the treatment of abnormal uterine bleeding in adolescence

摘要

Abstract Aim This article retrospectively analyzed the efficacy and safety of vaginoscopy in the treatment of adolescent abnormal uterine bleeding (AUB) in 204 cases of AUB. Method From January 1, 2007 to December 31, 2017, 204 patients with intact hymen who were admitted to our hospital due to AUB received vaginoscopy, and vaginoscopy did not damage the hymen. In this study, 4.5?mm and 6.5?mm hysteroscopy were used with a pumping fluid pressure of 100–120?mm Hg and a flow rate of 400?mL/min. All 204 vaginoscopy was successfully completed in intravenous anesthesia. Results Postoperative pathological examination confirmed that of the 204 patients, 53 patients had simple hyperplasia. There were 53 cases of polyps, 50 cases of endometrial gland hyperplasia and disordered arrangement, 35 cases of proliferative phase endometrium, five cases of bleeding phase endometrium, partial glandular secretion, three cases of complex hyperplasia and one case of decidua like change. Follow‐up data from 64 patients showed that 34 patients were effective after treatment. Stepwise logistic regression analysis suggested that endometrial thickness was associated with treatment outcome (HR, 0.875, 95% CI, 0.786–0.974, P = 0.014). There was no significant difference in drug use between patients with effective and ineffective treatment. Conclusion ‘No‐touch’ vaginoscopy is feasible for the diagnosis and treatment of adolescent AUB without destroying the intact hymen.