Dilatation and curettage fails to detect most focal lesions in the uterine cavity in women with postmenopausal bleeding
Epstein, Elisabeth LU ; Ramirez, Anette ; Skoog, Lennart and Valentin, Lil LU
(2001)
In Acta Obstetricia et Gynecologica Scandinavica
80(12).
p.1131-1136
- Abstract
- OBJECTIVE: To determine the prevalence of focally growing lesions in the uterine cavity in women with postmenopausal bleeding and endometrium > or = 5 mm and the extent to which such lesions can be correctly diagnosed by D&C. METHODS: In a prospective study, 105 women with postmenopausal bleeding and endometrium > or = 5 mm at transvaginal ultrasound examination underwent diagnostic hysteroscopy, D&C and hysteroscopic resection of any focally growing lesion still left in the uterine cavity after D&C. Twenty-four women also underwent hysterectomy. If the histological diagnosis differed between specimens from the same patient, the most relevant diagnosis was considered the final one. RESULTS: Eighty percent (84/105) of the... (More)
- OBJECTIVE: To determine the prevalence of focally growing lesions in the uterine cavity in women with postmenopausal bleeding and endometrium > or = 5 mm and the extent to which such lesions can be correctly diagnosed by D&C. METHODS: In a prospective study, 105 women with postmenopausal bleeding and endometrium > or = 5 mm at transvaginal ultrasound examination underwent diagnostic hysteroscopy, D&C and hysteroscopic resection of any focally growing lesion still left in the uterine cavity after D&C. Twenty-four women also underwent hysterectomy. If the histological diagnosis differed between specimens from the same patient, the most relevant diagnosis was considered the final one. RESULTS: Eighty percent (84/105) of the women had pathology in the uterine cavity, and 98% (82/84) of the pathological lesions manifested a focal growth pattern at hysteroscopy. In 87% of the women with focal lesions in the uterine cavity, the whole or parts of the lesion remained in situ after D&C. D&C missed 58% (25/43) of polyps, 50% (5/10) of hyperplasias, 60% (3/5) of complex atypical hyperplasias, and 11% (2/19) of endometrial cancers. The agreement between the D&C diagnosis and the final diagnosis was excellent (94%) in women without focally growing lesions at hysteroscopy. CONCLUSION: If there are focal lesions in the uterine cavity, hysteroscopy with endometrial resection is superior to D&C for obtaining a representative endometrial sample in women with postmenopausal bleeding and endometrium > or = 5 mm. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/1120553
- author
- Epstein, Elisabeth
LU
; Ramirez, Anette
; Skoog, Lennart
and Valentin, Lil
LU
- organization
- publishing date
- 2001
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- dilatation and curettage, endometrial pathology, hysteroscopy, postmenopausal bleeding, ultrasound
- in
- Acta Obstetricia et Gynecologica Scandinavica
- volume
- 80
- issue
- 12
- pages
- 1131 - 1136
- publisher
- Wiley-Blackwell
- external identifiers
-
- pmid:11846711
- scopus:0035690259
- ISSN
- 1600-0412
- DOI
- 10.1034/j.1600-0412.2001.801210.x
- language
- English
- LU publication?
- yes
- id
- 4a01e9a8-4548-43a4-aae1-679d4b9faafb (old id 1120553)
- date added to LUP
- 2016-04-01 15:54:11
- date last changed
- 2022-01-28 07:55:03
@article{4a01e9a8-4548-43a4-aae1-679d4b9faafb,
abstract = {{OBJECTIVE: To determine the prevalence of focally growing lesions in the uterine cavity in women with postmenopausal bleeding and endometrium > or = 5 mm and the extent to which such lesions can be correctly diagnosed by D&C. METHODS: In a prospective study, 105 women with postmenopausal bleeding and endometrium > or = 5 mm at transvaginal ultrasound examination underwent diagnostic hysteroscopy, D&C and hysteroscopic resection of any focally growing lesion still left in the uterine cavity after D&C. Twenty-four women also underwent hysterectomy. If the histological diagnosis differed between specimens from the same patient, the most relevant diagnosis was considered the final one. RESULTS: Eighty percent (84/105) of the women had pathology in the uterine cavity, and 98% (82/84) of the pathological lesions manifested a focal growth pattern at hysteroscopy. In 87% of the women with focal lesions in the uterine cavity, the whole or parts of the lesion remained in situ after D&C. D&C missed 58% (25/43) of polyps, 50% (5/10) of hyperplasias, 60% (3/5) of complex atypical hyperplasias, and 11% (2/19) of endometrial cancers. The agreement between the D&C diagnosis and the final diagnosis was excellent (94%) in women without focally growing lesions at hysteroscopy. CONCLUSION: If there are focal lesions in the uterine cavity, hysteroscopy with endometrial resection is superior to D&C for obtaining a representative endometrial sample in women with postmenopausal bleeding and endometrium > or = 5 mm.}},
author = {{Epstein, Elisabeth and Ramirez, Anette and Skoog, Lennart and Valentin, Lil}},
issn = {{1600-0412}},
keywords = {{dilatation and curettage; endometrial pathology; hysteroscopy; postmenopausal bleeding; ultrasound}},
language = {{eng}},
number = {{12}},
pages = {{1131--1136}},
publisher = {{Wiley-Blackwell}},
series = {{Acta Obstetricia et Gynecologica Scandinavica}},
title = {{Dilatation and curettage fails to detect most focal lesions in the uterine cavity in women with postmenopausal bleeding}},
url = {{http://dx.doi.org/10.1034/j.1600-0412.2001.801210.x}},
doi = {{10.1034/j.1600-0412.2001.801210.x}},
volume = {{80}},
year = {{2001}},
}