Objective To explore the value of outpatient non-anesthesia vaginal endoscopic technique for uterine lesions in postmenopausal women.

Methods 96 postmenopausal patients treated by outpatient hysteroscopy from January 2016 to January 2021 in Obstetrics and Gynecology Hospital of Fudan University were retrospectively analyzed, including 47 cases of vaginal endoscopy and 49 cases of traditional hysteroscopy. The two groups were compared with the operation time、the amount of bleeding, the amount of the distension fluid, creation of a false passage, the incidence of failure, patient pain score, incidence of complications and patients' post- surgery recovery.

Results For cases with surgery time less than 10 minutes (86% vs 61%)、intraoperative bleeding less than 3 mL(93% vs 73%), mild pain (VAS score≤3, 83% vs 63%), the duration of postoperative pain less than 2 hours (93% vs 71%), postoperative bleeding duration less than 7 days (98% vs 82%), surgical failure(11% vs 0), the ratio of which were higher in the vaginal endoscopy group than in the traditional hysteroscopy group, statistically significant (P < 0.05). For cases of nausea/vomiting(9% vs 29%), abnormal heart rate/blood pressure(12% vs 31%), the ratio of which were lower in the vaginal endoscopy group than in the traditional hysteroscopy, statistically significant (P < 0.05). There was no significant difference in the amount of the distension fluid and creation of a false passage between the two groups.

Conclusions Vaginal endoscopy technology is more minimally invasive and safer than traditional hysteroscopy with a certain failure rate. For postmenopausal female with intrauterine lesions, outpatient non-anesthesia vaginal endoscopy can be recommended as an examination method prior to the traditional hysteroscopy.