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 obtai ned after hysterectomy. Design: Retrospective clinical study. Setting: University-affiliate hospital. Patient(s): Three hundred ninety-seven patients with abnormal uterine bleed ing who underwent D&C and, within 2 months, hysterectomy because of histolo gic findings or persistence of symptoms. Main Outcome Measure(s): Comparison of histologic findings on D&C with thos e obtained after hysterectomy. Result(s): In 248 of 397 patients (62.5%), D&C failed to detect intrauterin e disorders subsequently found at hysterectomy; the sensitivity was 46%, th e specificity was 100.0%, the positive predictive value was 100.0%, and the negative predictive value was 7.1%. Conclusion(s): Dilatation and curettage is an inadequate diagnostic and the rapeutic tool for ail uterine disorders; this technique missed 62.5% of maj or intrauterine disorders, and all endometrial disorders were still present in the removed uterus. (Fertil Steril (R) 2001;75:803-5 (C) 2001 by Americ an Society for Reproductive Medicine.)