Hysteroscopic findings after unsuccessful dilatation and curettage for abnormal uterine bleeding

In recent years numerous articles have reported on the inaccuracies of the dilatation and curettage procedure, citing a false-negative rate of up to 10% to 15%. Indeed, several articles have reported that, in this era of simplified endoscopy, the blind dilatation and curettage should no longer play a significant role in gynecologic diagnosis, but should be replaced by hysteroscopic evaluation and directed biopsy. We report the hysteroscopic findings in 29 patients for whom a blind curettage was performed within the previous year for the purpose of diagnosing the cause of abnormal uterine bleeding and attempting its cure. The remarkably high incidence of apparently missed pathologic factors (mainly submucous myomata) adds to the data confirming the lack of precision of dilatation and curettage, and supports the contention that diagnostic hysteroscopy is an essential tool in the management of abnormal uterine bleeding and the prevention of unnecessary hysterectomies.