Although scientific research have previously studied using a hysteroscope and obtaining an endometrial sample to diagnose endometriosis, this is no longer a way of diagnosing endometriosis and is not suggested for this reason. Diagnosing endometriosis requires a surgical procedure to obtain tissue samples for examination under a microscope. Since the hysteroscope does not provide any tissue for examination, it cannot be used to make this diagnosis. In addition, during a hysteroscopy any visible lesions may be removed. This may include lesions of the uterus or ovaries that appear on ultrasound or during the surgery performed to diagnose endometriosis. These procedures are called "adhesions"otomies. " An otorhinolaryngologist (ear, nose, and throat doctor) may perform these procedures under local anesthesia. Endometriosis can be seen on a hysteroscopy and may require removal of tissue samples for examination under a microscope. A laparoscopy is required to make this diagnosis and treat any lesions found. Lesions of the uterus that appear on ultrasound or during surgery to diagnose endometriosis are called "adenomyosis" or "fibroids". Adenomyosis and fibroids may cause pain, bleeding, or both inside the uterus. They do not spread outside the uterus and are not cancerous.