Before the advent of ultrasound and office endometrial sampling, virtually every woman underwent dilatation curettage for treatment of abnormal bleeding. Up until the 1980’s, a D&C was done as an inpatient procedure using general anesthesia, and was intended to be treatment more than a method of diagnosis. Even at that time there was an awareness that a D&C, while able to sample representative tissue, often missed things, including fibroids and polyps. It was the invention of fiberoptic technology that permitted visualization of the uterine cavity with a hysteroscope that enabled evaluation of the entire uterine cavity.
Operative hysteroscopy, in which instruments are passed through the hysteroscope, is most commonly used for removal of fibroids and polyps.