Can we rely on blind endometrial curettage for complete removal of focal intrauterine lesion? A prospective clinical study - 21/03/20
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Abstract |
Objective |
To investigate the diagnostic and therapeutic efficiency of dilatation-curettage (D&C) combined with aspiration curettage for endometrial pathology compared to hysteroscopy alone in this study.
Material and methods |
A total of 143 patients who have suspicion of endometrial mass like lesion, increased endometrial thickness (>5-mm at menopause and/or endometrial thickness upper than 5-mm in patients under tamoxifen treatment due to breast cancer during 2-D transvaginal ultrasonography examination) were enrolled. All patients underwent procedures in order of hysteroscopy, D&C plus aspiration and second look hysteroscopy. Data for age, menopausal status, tamoxifen treatment, endometrial histology, hysteroscopy and D&C findings were recorded and statistically analyzed.
Results |
Initial hysteroscopy revealed focally growing endometrial lesion in 96 patients. Second look hysteroscopy showed persistent focal lesion in 77 patients (80 %) after D&C plus aspiration. Endometrial blind curettage failed to diagnose 42 % (25/60) of endometrial polyps, none of submucous myomas as well as 27 % (3/11) of premalignant and malignant endometrial lesions. The sensitivity, specificity, overall accuracy, positive predictive value and negative predictive value of hysteroscopy were found as 84.1 %, 83.3 %, 83.9 %, 93.8 %, and 63.8 %, respectively.
Conclusions |
Hysteroscopy showed significant superiority in the diagnosis and definitive treatment of endometrial pathologies specifically in focally growing endometrial lesions compared to D&C plus aspiration.
Le texte complet de cet article est disponible en PDF.Keywords : Hysteroscopy, Dilatation & curettage, Endometrial polyp
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Vol 49 - N° 4
Article 101696- avril 2020 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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