Critical review of dilatation and curettage in the diagnosis of malignant pathology of the endometrium.
The authors take into account all the Dilatation and Curettage done in the Obstetric and Gynaecological Clinic of the University of Siena during the past ten years, on hospitalized patients affected by postmenopausal uterine bleeding (PMB). Endometrial cancer resulted in 14.3% of the cases, in 41.4% of the cases the histological finding showed benign pathology of the endometrium, in 26.5% it was not possible to remove sufficient tissue from the uterine cavity for a diagnostic interpretation. In 14.6% of the cases, the diagnostic method showed premalignant or other than benign tissue. In the light of these results and considering the frequent complication which arise from this operative technique, the patients' stress, the high cost and the relatively low diagnostic reliability, the authors conclude that the routine use of this method is quite often excessive. The authors recommend, for the diagnosis of endometrial pathology, hysteroscopy associated with specific endometrial biopsy, undoubtedly the most up-to-date and less expensive technique, more acceptable to the patient and more sure than Dilatation and Curettage.