Use of Flexible Hysteroscopy in Prepubertal Aged Girls with Genital Complaints

Abstract

Objective: We describe our experience with flexible hysteroscopy and concomitant manual examination to explore the immature lower genital tract of seven prepubertal girls with genital complaints. Methods: Seven early prepubertal girls aged from 1 year 3 months to 5 years 9 months presented with abnormal vaginal discharge or bleeding or occluded vaginal outlet. All these girls with different indications for vaginal inspection underwent flexible hysteroscopy under anesthesia due to the potential for lack of cooperation and psychologic impact. Results: Intravaginal foreign bodies were found in two patients, together with their location and tissue reaction. The origins of vaginal bleeding were identified in two patients. Verification of vagina and cervix in three patients with ambiguous external genitalia showed no vertical fusion defects or congenital Müllerian duct abnormalities. Conclusion: The advantages of safety, convenience, and effectiveness suggest that flexible hysteroscopy under anesthesia is a good substitute for traditional vaginoscopy and may help in the diagnosis of genital complaints in selected prepubertal patients in the pediatric gynecology clinic.

Keywords

• flexible hysteroscopy
• pediatric gynecology
• prepubertal