Visualization of cervical, vaginal, or vulvar epithelium under 5–50 × magnification with and without dilute acetic acid to identify abnormal areas requiring biopsy. An office procedure.
Dilation & curettage (D&C)
Dilation of the cervix and curettage of the entire endometrial cavity, using a metal curette or suction cannula and often using forceps for the removal of endometrial polyps. Can usually be done in the office under local anesthesia or in the operating room under sedation or general anesthesia. D&C is often combined with hysteroscopy for improved sensitivity.
Blind sampling of the endometrium by means of a curette or small aspiration device without cervical dilation. Diagnostic accuracy similar to D&C. An office procedure performed with or without local anesthesia.
Removal of endocervical epithelium with a small curette for diagnosis of cervical dysplasia and cancer. An office procedure performed with or without local anesthesia.
Injection of radiopaque dye through the cervix to visualize the uterine cavity and oviducts. Mainly used in investigation of infertility, to identify a space-occupying lesion, or to confirm fallopian tube inserts (Essure®) sterilization.
Visual examination of the uterine cavity with a small fiberoptic endoscope passed through the cervix. Curettage, endometrial ablation, biopsies of lesions, and excision of myomas or polyps can be performed concurrently. Can be done in the office under local anesthesia or in the operating room under sedation or general anesthesia. Greater sensitivity for diagnosis of uterine pathology than D&C.
Visualization of the abdominal and pelvic cavity through a small fiberoptic endoscope passed through a subumbilical incision. Permits diagnosis, tubal sterilization, and treatment of many conditions previously requiring laparotomy. General anesthesia is used.
Saline infusion sonohysterography
Introduction of saline solution into endometrial cavity with a catheter to visualize submucous myomas or endometrial polyps by transvaginal ultrasound. May be performed in the office with oral or local analgesia, or both.