Office hysteroscopic treatment of vaginal bleeding and related pain after supracervical hysterectomy: A case report

Vaginal bleeding and pelvic pain are frequently observed after supracervical hysterectomy with preservation of the ovary. In this article, we describe original and successful office hysteroscopic partial epithelial ablation of the cervical stump with a bipolar instrument, in a patient suffering from vaginal bleeding and pain, occurred after supracervical hysterectomy. Hysteroscopy was performed on a 48-year-old Caucasian patient, which was brought to our attention for vaginal bleeding and associated pain 1 year after supracervical hysterectomy. The procedure was carried out in an office setting using the vaginoscopic approach, using the 4-mm continuous-flow operative office hysteroscope with a 2.9-mm rod lens. After introducing the hysteroscope into the cervical canal, a recess with hyperplastic residual epithelial tissue was usually found. We performed partial epithelial ablation with bipolar Versapoint Twizzle Electrode to minimize vaginal bleeding and pain by reducing hormone-responsive tissue. At 4 years of follow-up, the patient reported complete disappearance of pain and only few and irregular vaginal bleeding. Office hysteroscopic treatment of vaginal bleeding and associated pain after supracervical hysterectomy is a simple procedure that can be easily introduced into common clinical practice.