The gold standard investigation for assessing the female pelvis, tubal patency and uterine cavity is laparoscopy and hysteroscopy with a dye test. This is a day case operative procedure which is performed in the operating theatres at the Lister Hospital under general anaesthetic.
A small (5mm diameter) telescope (laparoscope) is inserted through a tiny 1cm incision inside the umbilicus (tummy button). A second 1cm incision in the bikini line is used to introduce an instrument to enable the uterus, ovaries and tubes to be examined carefully. Dye is injected through the cervix and the tubes are examined to see if they fill with dye and are open to allow dye to pass through into the pelvis.
Laparoscopy also enables a diagnosis of endometriosis to be made if this is present and can see whether there is any scar tissue (adhesions) around the tubes or ovaries. It may be possible to treat these at the same time. Photographs are taken during the procedure so we can show you what has been found. A dissolving stitch is used in each incision and patients are usually able to go home later the same day.
The uterine cavity is assessed by introducing a small (5mm) telescope (hysteroscope) gently through the opening of the cervix into the uterine cavity. It is possible to see if there are any polyps, fibroids or congenital uterine septum inside the cavity and to see the openings of the fallopian tubes and whether they appear normal. It may be possible to surgically treat polyps and small fibroids identified during the procedure. See here for further information about operative laparoscopy and hysteroscopy.
