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The tip of the diagnostic scope was withdrawn through the external cervical os.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.