DOES HYSTEROSCOPY IMPROVE UPON THE SENSITIVITY OF DILATATION AND CURETTAGE IN THE DIAGNOSIS OF ENDOMETRIAL HYPERPLASIA OR CARCINOMA

Objective. The objective of this study nas to determine whether hyster oscopy improved upon the diagnostic sensitivity of dilatation and cure ttage (D+C) in the detection of endometrial hyperplasia and carcinoma. Methods. A retrospective chart review was conducted of all patients u ndergoing hysteroscopy/D+C for abnormal uterine bleeding between 1991 and 1995. Hysteroscopic impressions and D+C diagnoses were compared. R esults. Three hundred seventy-three patients were included in the stud y, Of the 61 patients with D+C demonstrating hyperplasia, the hysteros copic impression was hyperplasia in 32 (52%). Of the 10 patients with D+C demonstrating carcinoma, the hysteroscopic impression was hyperpla sia in 8 (80%) and carcinoma in 2 (20%). Two additional cases of carci noma were diagnosed within 6 months of hysteroscopy/D+C, and both had been missed on both hysteroscopy and D+C. Of 204 patients with a norma l hysteroscopic impression, 23 (11%) had hyperplasia on D+C. Conclusio ns. Hysteroscopy did not improve upon the sensitivity of D+C in the de tection of endometrial hyperplasia or carcinoma. (C) 1998 Academic Pre ss.