Clinical value of dilatation and curettage for abnormal uterine bleeding

Tabata, Tsutomu; Yamawaki, Takaharu; Ida, M.; Nishimura, Kazuaki; Nosé, Yukihiko; Yabana, Tadashi

doi:10.1007/s004040000100

Cited by 13 publications

(16 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Curetting is still the standard procedure for evaluating endometrial lesions such as carcinoma and hyperplasia, but this procedure has several deficiencies. Besides of its tendency to cause pain and injury, as well as its cost (Tabata et al 2001), curetting can only evaluate less than half of the uterine cavity in approximately 60 % of dilatation and curettage (D&C) procedures, which can result in false-negative diagnoses (Kipp et al 2008). Therefore, there is an urgent need for alternative devices which can be used for early detection of endometrial lesions, especially carcinoma and its precursors.…”

Section: Introductionmentioning

confidence: 99%

Endometrial sampling devices for early diagnosis of endometrial lesions

Li²,

et al. 2016

J Cancer Res Clin Oncol

View full text Add to dashboard Cite

PurposeEndometrial carcinoma is the most common gynecologic malignancy in both developed and some developing countries. Unlike cervical cancer, for which there is routine screening, only patients symptomatic for endometrial carcinoma typically seek medical help for its diagnosis and treatment. Dilatation and curettage (D&C) has been the standard procedure for evaluating suspicious endometrial lesions. The discomfort and injury caused by the D&C procedure, however, restrict its use as a screening method for early diagnosis of endometrial lesions. High-risk endometrial cancer patients would benefit from an effective and low-cost screening test. In recent years, several endometrial devices have been developed and proposed as screening tools.MethodsWe have reviewed and evaluated the literature relating to the endometrial sampling devices in clinical use or clinical trials, with the goal of comparing devices and identifying the most appropriate ones for screening for endometrial lesions. Eligible literature was identified from systematic PubMed searches, and the relevant data were extracted. Comments, letters, unpublished data, conference proceedings, and case reports were excluded from our search. Seventy-four articles on endometrial sampling devices were obtained for this review.ResultsThe main screening devices for endometrial carcinoma are aspiration devices (such as the Vabra aspirator), Pipelle, Tao Brush, and SAP-1 device. Among these devices, the Tao Brush is the most promising endometrial sampler for screening for endometrial lesions. However, its sampling insufficiency, cost, and unsuccessful insertion rate (20 % in nulliparous and 8 % in parous women) are problematic.ConclusionsA more accurate and low-cost endometrial sampler, with improved specimen sufficiency and higher sensitivity for endometrial lesions, needs tobe developed and clinically verified.

show abstract

Section: Introductionmentioning

confidence: 99%

Endometrial sampling devices for early diagnosis of endometrial lesions

Li²,

et al. 2016

J Cancer Res Clin Oncol

View full text Add to dashboard Cite

show abstract

“…While other studies showed 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 15 . In other study 16 showed 2.5% of the patients were found to have endometrial carcinoma with median age 56.6 years and 6% of the patients were found to have endometrial hyperplasia whose age was 47.7years, of those 3.6 % had simple hyperplasia and 2.4% complex hyperplasia 16 , while in this study 2 out of 275 (0.73 %) of the patients were found to have endometrial carcinoma and in older than 45 years age group, while 25 out of 275 (9.09%) were found to have endometrial hyperplasia, of those 8.36% had simple hyperplasia and 0.73% complex hyperplasia. The criteria for adequacy and common artifacts in endometrial biopsies, as well as the interpretation of endometrial biopsies in general, may cause problems for pathologists.…”

Section: Figurementioning

confidence: 82%

Assessment of three methods of curetting orientation for women with excessive uterine bleeding

Alrawi¹,

Rasul²

2013

ZJMS

View full text Add to dashboard Cite

Background and objective: Dilation and curettage (D&C) is commonly performed for the diagnosis of gynecological conditions leading to excessive uterine bleeding. The aim of this study was to evaluate different methods of curetting orientation to optimise the diagnosis of common pathological lesions associated with excessive uterine bleeding. Methods: Data and cases retrieved from women presented with excessive uterine bleeding and underwent D&C, at a private histopathology laboratory in Erbil city, Kurdistan region, from December 2010 to January 2012. Three methods of curetting orientation were carried out on 275 patients. Light microscopical study was done to asses the cause of excessive uterine bleeding. Results: A total of 274 out of 275 cases were found to have optimal tissue processing, embedding and histological examination. When the tissue specimens attached to filter paper and gauze, two out of 275 cases were found to have endometrial adenocarcinoma. Moreover, out of 275 cases, 198 were found to have dysfunctional uterine bleeding (hormonal imbalance) and 25 cases were found to have endometrial hyperplasia. Conclusion: Optimal tissue processing, embedding and histological orientation can be attained by using filter paper and/or gauze. Dilation and curettage is an adequate diagnostic tool for endometrial hyperplasia and carcinoma.

show abstract

“…This increase of life expectancy leads to an increasing number of older patients suffering from degenerative disorders. Furthermore, advanced age is associated with an increased morbidity in gynaecology and obstetrics generally [2,3]. One example for an age-related disease is the pelvic organ prolapse leading to recurrent genital ulcerations as well as urinary incontinence occasionally and thus restraining the quality of life [4].…”

Section: Introductionmentioning

confidence: 99%

“…In general, hysterectomy is one of the most frequently done gynaecological major surgical procedures and in up to 90% performed to treat benign diseases [8,9]. However, with advanced age the incidence of endometrial hyperplasia and malignant diseases increases as well [2]. Pre-existing comorbidity is related to the patient's age.…”

Section: Introductionmentioning

confidence: 99%