Hysteroscopy uses a hysteroscopy, which is a thin telescope that is inserted through the cervix into the uterus. Modern hysteroscopy are so thin that they can fit through the cervix with minimal or no dilation. Because the inside of the uterus is a potential cavity, like a collapsed air dome, it is necessary to fill (distend) it with either a liquid or a gas (carbon dioxide) in order to see. I do most diagnostic hysteroscopy in the office using local anesthesia. If a patient is particularly anxious, or if I have a concern that she may be uncomfortable, I can do the procedure under mild sedation. View through a hysteroscope This is a view through a hysteroscopy during office hysteroscopy. It shows the inside of a uterus with two intracavity myomas on the back wall. The upper portion of the photograph shows the top of the uterus, which is normal. Fibroids like this can cause severe cramping (dysmenorrhea), heavy menstrual periods (menorrhagia) and bleeding between periods (metrorrhagia.) These fibroids were quickly and accurately diagnosed by hysteroscopy.