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Cervical conization: when is uterine dilatation and curettage also indicated?
American Journal of Obstetrics and Gynecology
|August 15, 1983
Summary
Routine dilatation and curettage (D&C) alongside cervical cone biopsy is often unnecessary. A review found no endometrial abnormalities in D&C specimens, suggesting D&C should be reserved for specific patient groups.
Area of Science:
- Gynecology
- Surgical Pathology
Background:
- Cervical cone biopsy, or conization, is a primary treatment for cervical intraepithelial neoplasia.
- Conization is frequently performed concurrently with uterine dilatation and curettage (D&C).
Purpose of the Study:
- To evaluate the necessity of routine D&C as an adjunct to conization.
- To identify specific criteria for recommending D&C with conization.
Main Methods:
- Retrospective review of 128 cone biopsies performed over a 3-year period.
- Analysis of 114 concurrent D&C specimens for endometrial abnormalities.
Main Results:
- No endometrial abnormalities were detected in any of the 114 D&C specimens.
- Routine D&C is not supported by current findings for patients undergoing conization.
Conclusions:
- D&C is not warranted as a routine accompaniment to conization.
- Specific indications for combining D&C with conization include peri- or postmenopausal status, suspected intrauterine abnormalities, and abnormal glandular cells on cytology.
- Implementing these criteria could reduce the need for D&C in 86% of cases.