Advanced

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:
author
organization
publishing date
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
2008-06-27 08:45:37
date last changed
2018-02-18 04:22:33
@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},
  keyword      = {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},
  volume       = {80},
  year         = {2001},
}