Background:Ourobjective was to investigate the conformity between endometrial tissue samplesobtained by preoperative dilatation and curettage (D&C) and those ofpost-hysterectomy specimens assessing its adequacy.
Methods: Thisretrospective cohort study included 829 women who underwent hysterectomybetween January 2010 and June 2017 in Benha University Hospital. Thehistopathological examination reports of both D&C as well as hysterectomybiopsies were analyzed and compared. Results: Dilatation and curettageprovides sensitivity (89.5%), specificity (99.6%), positive (96.2%) andnegative (98.9%) predictive values for malignant endometrial pathologies. Theaccuracy was (96.
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1%) and (99.6%) for malignant pathologies diagnosed fromcurettage material for pre and postmenopausal women respectively. There is agood inter-method agreement (Weighted ?=0.756) between D&C andhysterectomy samples. Conclusions: D&C continues to be an acceptableand accurate diagnostic procedure for detecting wide range of endometrialpathologies, especially malignancies in postmenopausal women.Key words: Dilatationand curettage; endometrial biopsy; hysterectomy.Background For years,gynecologists routinely tend to obtain an endometrial sample before hysterectomyto detect any asymptomatic pathology as well as to design an effectivemanagement plan. 1 Since dilatation and curettage (D&C) was firstdescribed by Recamier in 1943, it became the tool of choice for routine endometrialsampling and a frequently used diagnostic procedure worldwide.
2 Althoughnewer techniques now are available for uterine cavity visualization ashysteroscopy and endometrial sampling like Pippelle suction curette, D&Cstill has a role where these technologies are not available or cannot beafforded. 3Althoughmany reported that D&C is the “gold standard” for endometrial sampling asit is accurate for the endometrial cancer detection. 4, 5 Others consideredD&C as inaccurate diagnostic tool for intrauterine pathologies management. Theyrecorded frequently missed focal uterine lesions as endometrial polyps and alsohyperplasia by preoperative D&C.
6, 7 Furthermore, D&C usenecessitates anesthesia administration, adds extra hospital costs and may becomplicated by infection, uterine perforation or cervical tears. 6, 8As the debate ofobtaining an endometrial sample before hysterectomy by which technique remainsunsolved and the efficacy of D&C is questionable, the aim of the currentstudy was to examine the validity of performing the pre-hysterectomy D&C.In addition, we investigated the agreement between the results of thehistopathological examination of the D&C and hysterectomy specimens.