For culdoscopy (also known as transvaginal hydrolaparoscopy or THL), we use another narrow telescope inserted via the back of the vagina to check the outside of your uterus (womb), fallopian tubes and ovaries. We instill some saline into your pelvis, and this give us a good view of your pelvis (you can see a fallopian tube on the right and part of the ovary on the left of the picture). We look for problems such as endometriosis or adhesions (scar tissue) which can both affect your fertility. At the end, we use a blue dye to see if your fallopian tubes are patent.

Unlike laparoscopy, which involves inserting a larger telescope through your umbilicus (tummy button) and is generally done under general anaesthesia, culdoscopy leaves no external scars and can be performed under local anaesthesia. The view at culdoscopy is admittedly more limited than at laparoscopy (eg. we cannot see the upper abdomen), but this is usually not important in cases of infertility. A further difference between culdoscopy under local anaesthesia and laparoscopy under general anaesthesia is that we can only "look" at culdoscopy but cannot "do" if something is found which requires treatment. If that is the situation in your case, you will be offered a date for admission as an in-patient for surgery, and this will usually be laparoscopic surgery. In the majority of cases, however, we are pleased to find that the pelvis is totally normal and there is no need for surgery.

Culdoscopy should not take long. As with hysteroscopy, you can follow the procedure on the television screen if you wish.

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