Hymen, Godsend or Curse?
Surgical Outpatient Hysteroscopy Using Vaginoscopic Access in Patients with Preserved Hymen

Czech version

Authors: Jana Daňková Kučerová ¹; Petr Kovář ²; Tomáš Adamus ³
Authors‘ workplace: Gynprenatal s. r. o., Havířov, vedoucí lékař MUDr. Petr Kovář ¹; Katedra chirurgických oborů (gynekologie) LF Ostravské univerzity v Ostravě, vedoucí katedry doc. MUDr. Pavel Zonča, Ph. D., FRCS ²; Katedra biomedicínských oborů, LF Ostravské univerzity v Ostravě, vedoucí katedry doc. RNDr. Kristian Šafarčík, Ph. D. ³
Published in: Prakt Gyn 2014; 18(1): 71-74
Category: Gynecology and Obstetrics: Review Article

Overview

Introduction:
Virginity in fertile age is not a very frequent condition in Czech Republic and it is not especially valued, loosing it does not discredit women. However, in each gynecologic practice there are groups of woman, who are virgos, examination is limited, diagnosis and treatment of gynecologic problems originated in patologic endometrial changes could be difficult.

Methods:
We use vaginoscopic access standartly in our practice, it means without using gynecological speculum, fixation cervix by forceps, without intrumental dilatation of cervix and also without paracervical block. This method is useful for all patients, especially for women with narrow vagina, nulliparous, postmenopausal women and also for women with preserved hymen.

Results:
In the last four years we have taken care of six patients with preserved hymen by office hysteroscopy (age 17 to 47 years). In two cases it was diagnostical hysteroscopy with biopsy of endometrium, in three cases ablation of endometrial polypus and in the last case ablation of endocervical polypus with biopsy of endometrium. There was no damage of hymen or another complication in all the cases, all the patients tolerated the procedure well and were immediatly released home afterwards.

Conclusion:
Offices hysterocopy using vaginoscopic access is an highly beneficial method in diagnosis and surgery of uterine cavity in patients with preserved hymen, it should be, because of its atraumatic treatment, the method of choice.

Key words:
hymen – hymen-safe hysteroscopy – office hysteroscopy – preserved hymen – vaginoscopic access

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