[Exploration of the uterine cavity in the gynecologic preoperative diagnosis]

The diagnostic accuracy of dilatation and curettage (D & C) was studied comparing retrospectively the results of histologic findings of D & C with the correspondent specimen from hysterectomy.

During five years, at the Institute of Gynecology and Obstetrics, II University of Studies in Naples, 260 women underwent hysterectomy, 160 of which underwent D & C prior to hysterectomy. The histologic findings were classified in: a) physiological endometrium; b) hyperplasia; c) polyps; d) atrophia; e) adenomatous hyperplasia; f) adenocarcinoma. During the period January 1989-October 1993, 260 patients underwent hysterectomy. The age was between 32 and 65 years. The indications to the intervention were: menometrorrhagia, hypogastric pains, dysmenorrhea, metrorrhagia, genital prolapse, urinary incontinence, anemia. Two hundred-sixty patients underwent hysterectomy, 160 of which underwent D & C prior to hysterectomy. Curettage was performed using a right size curette after dilatation of the uterine cervix using Hegar's metallic dilatator. Patients were submitted to general anesthesia. Histologic tissues were fixed with formalin and were sent to the Institute of Anatomopathology for examinations.

The histologic results obtained by cavitary exploration have been compared with those reached by the analysis of the surgical samples. The results obtained confirm the reliability of D & C for the identification of endometrial lesions.

Therefore, the diagnostic utility of cavitary exploration before hysterectomy is confirmed, particularly in selected cases.