Assessment of three methods of curetting orientation for women with excessive uterine bleeding
DOI:
https://doi.org/10.15218/zjms.2013.0040Keywords:
curetting, uterine bleedingAbstract
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.
Metrics
References
Gregory A. Dilation and sharp curettage (D&C) for abortion. Women's Health. Available from WebMD. http://women.webmd.com/dilation- and-sharp-curettage-dc-for-abortion. Retrieved 2007.
Hayden M. Dilation and curettage (D&C) for dysfunctional uterine bleeding. Healthwise. Available from WebMD. http://www.webmd.com/sexual-conditions/Dilation-and-curettage-DC-for-dysfunctional-uterine-bleeding. Retrieved 2007.
Anastasiadis PG, Koutlaki NG, Skaphida PG, Galazios GC, Tsikouras PN, Liberis VA. "Endometrial polyps: prevalence, detection, and malignant potential in women with excessive uterine bleeding. Eur J Gynaecol Oncol.2000; 21:180–183.
Wolman I, Altman E, Fait G, Har-Toov J, Gull I, Amster R, Jaffa A. Evacuating retained products of conception in the setting of an ultrasound unit. Fertil Steril. 2009; 91:1586–88.
Friedler S, Margalioth EJ, Kafka I, Yaffe H. Incidence of post-abortion intra-uterine adhesions evaluated by hysteroscopy--a prospective study. Hum. Reprod.1993; 8: 442–4.
Schenker JG, Margalioth EJ. Intra-uterine adhesions: an updated appraisal. Fertility Sterility, 1982; 37:593–610.
Chambers JT, Chambers SK. Endometrial sampling: When? Where? Why? With what? J. Clin Obstet Gynecol;1992; 35:28-39.
Albers JR, Hull SK, Wesley RM. Excessive uterine bleeding. J. Am Fam Physician. 2004; 69: 1915-26.
Rosai J. Rosai and Ackerman’s Surgical Pathology, 10th ed., Mosby, 2011.
Robertson G. Screening for endometrial cancer. Med J Aust 2003; 178:657-9.
Salvesen HB. Mass screening against endometrial carcinoma. Tidsskr Nor Laegeforen. 2002;122:1767.
Gull B, Karlsson B, Milsom I, Granberg S. Can ultrasound replace dilation and curettage? A longitudinal evaluation of postmenopausal bleeding and transvaginal sonographic measurement of the endometrium as predictors of endometrial cancer. Am J Obstet Gynecol. 2004; 191:677.
Yarandi F, Izadi-Mood N, Eftekhar Z, Shojaei H, Sarmadi S. Diagnostic accuracy of dilatation and curettage for excessive uterine bleeding. J Obstet Gynaecol Res. 2010; 36:1049-52.
Epstein E, Ramirez A, Skoog L, Valentin L. Dilatation and curettage fails to detect most focal lesions in the uterine cavity in women with postmenopausal bleeding. Acta Obstetricia et Gynecologica Scandinavica 2001; 80:1131-6.
Bettocchi S, Ceci O, Vicino M, Marello F, Impedovo L, Selvaggi L. Diagnostic inadequacy of dilatation and curettage. Fertil Steril 2001; 75(4):803-5.
Tabata T., Yamayaki, T. The value of dilatation and curettage for excessive uterine bleeding Arch.Gynecol.Obstet. 2001; 264:174-176.
McCluggage WG. My approach to the interpretation of endometrial biopsies and curettings. J Clin Pathol. 2006; 59:801-812.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2013 Rafal Abdul Razaq Al-rawi, Hersh Rasul ----- (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The copyright on any article published in Zanco J Med Sci is retained by the author(s) in agreement with the Creative Commons Attribution Non-Commercial ShareAlike License (CC BY-NC-SA 4.0).
