Authors' reply


Dear Sir

Vaginoscopy is endoscopic inspection of the vagina. The vaginoscopic or ‘no touch’ approach to hysteroscopy is a technique that obviates the use of unnecessary instrumentation of the lower genital tract, which is especially germane in the conscious outpatient because it is associated with less pain.[1] Visualisation of the external genitalia should form part of hysteroscopic examination. However, routine placement of a vaginal speculum is unnecessary to visualise the cervix if a hysteroscopy is performed because an excellent view is obtained endoscopically. Bimanual examination, however, should be performed at the discretion of the operator and is mandatory if abnormality is suspected.