Is routine performance of the uterine cervix canal curettage prior to the curettage of the uterine cavity justified?

OBJECTIVES: Endocervical curettage (ECC) together with the dilatation and curettage of the uterine cavity (D & C) is routinely performed in everyday clinical practice. The aim of this study is to assess the rationale of the performance of ECC prior to D & C in indications other than abnormal uterine bleeding (AUB).

MATERIAL AND METHODS: Case histories of 736 patients after ECC performed in the 1st Department of Obstetrics and Gynaecology, Medical University of Warsaw, were analyzed retrospectively, the indications for the procedure - age, menopausal status, parity, procedure operator's experience - as well as the result of the histopathology examination were taken into account. Three groups of patients were distinguished based on the indications for the procedure.

RESULTS: In 645 (87.6%) of cases normal histopathology results were obtained. 40 (5.4%) cases were abnormal. 31 cases of uterine cervix dysplasia were disclosed (CIN 1-20; CIN 2-5; CIN 3-6), 8 cases of endometrial cancer and 1 case of cancer of the uterine cervix were disclosed. In 51 (7%) of cases tissue material for histopathology examination was not obtained. In patients where ECC and D & C were performed due to indications other than abnormal bleeding from uterine cavity, no abnormal results were revealed. In addition, in this group the highest number of non-diagnostic ECCs was reported (11.59%; p < 0.05).

CONCLUSIONS: In the case of endometrial biopsy for indications other than AUB routine ECC prior to D & C need not be performed.