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Diagnostic inadequacy of dilatation and curettage
S Bettocchi1, O Ceci, M Vicino
1Second Institute of Obstetrics and Gynecology, University of Bari, Bari, Italy. stefanoendo@tin.it
Objective:
To assess the diagnostic inadequacy of dilatation and curettage (D&C) by comparing histologic findings with this technique with those obtained after hysterectomy.
Design:
Retrospective clinical study.
Setting:
University-affiliated hospital.
Patient(S):
Three hundred ninety-seven patients with abnormal uterine bleeding who underwent D&C and, within 2 months, hysterectomy because of histologic findings or persistence of symptoms.
Main Outcome Measure(S):
Comparison of histologic findings on D&C with those obtained after hysterectomy.
Result(S):
In 248 of 397 patients (62.5%), D&C failed to detect intrauterine disorders subsequently found at hysterectomy; the sensitivity was 46%, the specificity was 100.0%, the positive predictive value was 100.0%, and the negative predictive value was 7.1%.
Conclusion(S):
Dilatation and curettage is an inadequate diagnostic and therapeutic tool for all uterine disorders; this technique missed 62.5% of major intrauterine disorders, and all endometrial disorders were still present in the removed uterus.