Diagnostic inadequacy of dilatation and curettage.
OBJECTIVE
To assess the diagnostic inadequacy of dilatation and curettage (D&C) by comparing histologic findings with this technique with those obtained after hysterectomy.


METHODS
Retrospective clinical study.


METHODS
University-affiliated hospital.


METHODS
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.


METHODS
Comparison of histologic findings on D&C with those obtained after hysterectomy.


RESULTS
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%.


CONCLUSIONS
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.
Bettocchi
S
S
Second Institute of Obstetrics and Gynecology, University of Bari, Bari, Italy. stefanoendo@tin.it
Ceci
O
O
Vicino
M
M
Marello
F
F
Impedovo
L
L
Selvaggi
L
L
D001284:Atrophy; D004107:Dilatation and Curettage; D016889:Endometrial Neoplasms / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D006965:Hyperplasia; D007044:Hysterectomy; D011127:Polyps / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014591:Uterine Diseases / Q000473:pathology* / Q000601:surgery; D014592:Uterine Hemorrhage / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D014594:Uterine Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery