Panoramic hysteroscopy with directed biopsies vs. dilatation and curettage for accurate diagnosis

Sixty-six women underwent panoramic hysteroscopy prior to dilatation and curettage. In 51 of these patients, a directed biopsy was performed through the hysteroscope. The indications for surgery were abnormal bleeding, postmenopausal bleeding, leiomyoma with bleeding, follow-up for adenomatous hyperplasia, infertility with bleeding and lost intrauterine devices with bleeding. In 48 cases the results of hysteroscopy and curettage were in agreement. Hysteroscopy revealed more information than curettage in 16 patients, whereas curettage revealed more information than hysteroscopy in only 2. Thus, panoramic hysteroscopy may prove to be superior to curettage in making an accurate diagnosis of pathology in the uterine cavity.