Hysteroscopy and Endometrial Curettage. Which one is the better choice?

Many patients face this dilemma since some doctors prefer Dilation and Curettage to hysteroscopy or the reverse.

Which are the clinical cases that this dilemma could be placed?

• Heavy menstrual bleeding
• Postmenopausal bleeding (vaginal bleeding after menopause)
• Endometrial polyps

Which is the most appropriate treatment?

According to updated literature, there is no doubt that  for all the above clinical cases  a hysteroscopy should be performed.

Why is Hysteroscopy recommended?

The accuracy of the operation is great; due to high-definition images which provide us the opportunity to assess the uterine cavity.

Doctor inserts fine instruments  through the hysteroscope and a removal of polyps or a biopsy takes place under camera guidance with high accuracy.

Why Hysteroscopy is more beneficial than Dilation and Curretage (D&C)?

Dilation and Curretage (D&C) is a blind procedure because there is no depiction of the endometrial cavity. The insertion of the instruments and the whole procedure is performed “blindly” without visual guidance.

Diagnostic D&C can detect endometrial cancer in a rate of 70% because endometrial abnormalities cannot be seen, so it is taken a sample in a blind fashion.
In other words, curettage makes an incorrect diagnosis in 3 out of 10 cases.

In case of a polyp presence, it is common D & C to cause polyp fragmentation and as a result the symptoms persist and unfortunately the patient will repeat the procedure.

How do I decide which option is better for me?

Talk to Gynecologist - Endoscopic surgeon Dr. Marinakis.

Doctor should examine you in order to be assured that there is an indication for a Diagnostic Hysteroscopy.

If they have discouraged you from Hysteroscopy, and you do not have enough information not only about the indications of the procedure, but also about your treatment planning, you may be in the wrong place!

Overall, hysteroscopy is a really safe procedure; however every single medical practice is safe only if it is managed by a specialist.

Gynecologist Dr. Marinakis specialises in gynecological hysteroscopy. He is certified in advanced laparoscopy and hysteroscopy by Royal College of Obstetricians and Gynecologists. He was also a member of Laparoscopic training unit “MATTU” in United Kingdom.

How much does a hysteroscopy cost?

The cost of a diagnostic hysteroscopy is low and it usually depends on your health insurance cover.