Methods
The procedures were performed in the University Hospitals Birmingham on
the Good Hope and Heartlands sites.
The vaginoscopy, hysteroscopy and endometrial sampling procedures were
explained as per protocol. The use of a ‘no touch’ Endosampler technique
without a speculum was further explained.
3 patients requested to have the vaginoscopy and endometrial sampling
without a speculum due to prior adverse experiences or personal choice.
The diagnostic vaginoscopic procedure was undertaken in the traditional
manner and completed uneventfully to the point of scope withdrawal.
The tip of the diagnostic scope was withdrawn through the external
cervical os. The tip of the scope was then maintained in the distended
vaginal vault, maintaining the external cervical os and ectocervix in
the field of view.
An Endosampler (3mm diameter, 240 mm length) was then introduced into
the vagina and under direct visualisation of the diagnostic scope, the
curved distal end of the sampler tube (image 1) was passed through the
external os and henceforth into the uterine cavity.
With the Endosampler now in the uterine cavity, the scope was removed
from the vagina. The scope and Endosampler were not within the
endocervical or uterine cavity simultaneously.
A blind endometrial biopsy was obtained in the traditional manner after
the uterine cavity was emptied of any remaining saline through the
attached syringe.