OBJECTIVE: To evaluate the diagnostic inadequacy of dilatation and curettage (D&C) by comparing histologic findings derived from D&C with histologic findings obtained after hysterectomy procedure. In this retrospective study we sought to evaluate the diagnostic accuracy of D&C. MATERIAL-METHODS: 259 patients with abnormal uterine bleeding were assessed. All of the women had performed gynecologic and ultrasonographic examination, after that they underwent D&C procedure with anesthesia. Hysterectomy was performed because of histologic findings or persistence of symptoms. We tried to compare histologic diagnosis in D&C and after hysterectomy for each patient. RESULTS: We studied the 259 patients who underwent hysterectomy within 2 months of D&C because of histologic findings on D&C or persistence of symptoms. 54.5% of the women had no pathology in D&C techniques. 59.5% of other patients are the pathologic disorders still present on hysterectomy in the same patients. In 105 of 259 patients, D&C failed to detect intrauterine disorders subsequently found at hysterectomy. After hysterectomy, in 227 of 259 patients were found additional pathologic disorders with the hystologic diagnosis in D&C. CONCLUSIONS: D&C involves additional hospital costs and risk of complications; uterine perforation, infection and laceration of the cervix. If there are lesions in the uterus, dilatation and curettage is an inadequate diagnostic tool. D&C missed 40.5% of major intrauterine disorders and endometrial lesions were still present in the remowed uterus. It can not curative tool. For these reasons, it has been suggested that D&C can be replaced by alternative and more accurate methods of diagnosis for intrauterine disorders.
Keywords: Endometrial pathology, hysterectomy, dilatation and curettage