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Has anyone had a Hysteroscopy biopsy vs a D&C for uterine biopsy?
Has anyone had a hysteroscopy done instead of a D&C for uterine biopsy after postmenopausal bleeding?
I am 74 and had two episodes of slight spotting. My gynecologist did an exam and I had a transvaginal ultrasound, both were normal so my Dr didn't think a biopsy to check for cancer was needed, but said she'd do a biopsy if I wanted one. I don't want the in-office biopsy because I've had that done before and it was very painful. She suggested the MyoSure procedure which is a hysteroscopic procedure done under sedation and is less invasive than a D&C. But, the MyoSure brochure says it mainly. used to remove fibroids and polyps. Also, some research I've done said "The use of hysteroscopy in endometrial cancer is not established as there is concern that cancer cells could be spread into the peritoneal cavity." Other studies say it's as safe as a D&C.
I want to ask for a biopsy for reassurance that the spotting is not due to cancer, but I'm wondering if a D&C would be the better procedure. I'm going to ask my Dr but wanted to ask if anyone else had the MyoSure procedure done after abnormal spotting?
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I'm sorry to hear that. I have a hysterectomy scheduled for Monday, but I don't think it includes a D&C. Are you saying the Hysterectomy is a better gauge of cancer than a D&C?
@liz1971 Welcome to Mayo Clinic Connect and to our Gynecological Cancers Support Group. Two months from when you first noticed the spotting is a long time. After I noticed spotting it took me two months to get from the initial exam in the doctor's office to an ultrasound and then to hysteroscopy and D&C. I would have liked that whole process to go more quickly but that did not seem possible at the time.
You mentioned that you had 4 "periods" in 2 months. May I ask your age and if you are post-menopausal?
From what I have read vaginal spotting of blood in a post-menopausal woman is not normal. It should be thoroughly investigated as the spotting could occur for different reasons but one of the reasons is a suspicion of uterine cancer. It sounds like your doctor did try to investigate by performing a biopsy in the office but was unable to continue because if your pain level.
Do you know the results of your vaginal ultrasound? Or is that ordered for after the hysteroscopy? From what I've seen here from other women in this group the sequence has been this: If a woman did not have an endometrial biopsy in the doctor's office then they have an ultrasound. If that shows something concerning the next step is often hysteroscopy and D&C.
Since you will be under anesthesia I am wondering if your doctor plans a biopsy with the hysteroscopy?. In order to biopsy the endometrial lining of the uterus a tissue sample is needed. You could ask your doctor if a D&C is planned along with the hysteroscopy.
Cleveland Clinic: Hysteroscopy (there is more information about a D&C at the bottom of this page).
- https://my.clevelandclinic.org/health/treatments/10142-hysteroscopy
Do you have any other questions?
Based on my experience, my hysterectomy pathologist report is the gold final results. The reason I did D&C is that my biopsy did not show cancer clearly, so unsure if do hysterectomy, but the cut off uterus shows it is cancer, so only hysterectomy to cuff of the ulterus can tell the final results. D&C only a test, but may miss the focal spot which has cancer.
Vaginal ultrasound and biopsy should tell if need to do hysterecomy.
You should definitely get clarification from your doctor. It seems strange that she wouldn't be doing a D&C and a hysteroscopy. Seems it would be the most thorough, and if you are going through the process of being under anesthesia, you should get it all done. Don't wait; time really is of the essence.
After my first episode of light spotting, my doctor performed an exam and I had a vaginal ultrasound. Both were normal so my doctor said nothing further needed to be done. When I had light spotting a second time, my doctor and I agreed to get a biopsy. My doctor explained that a hysteroscopy includes a camera inserted into the uterus and an instrument is used to grab samples of the lining for biopsy. A D&C will remove any remaining tissue to ensure the entire lining is biopsied. If results are benign, I don't think a doctor would do a hysterectomy unless there are other indications of cancer. If no cancer is found, in my case the doctor said my slight spotting would most likely be due to vaginal atrophy.
I don’t think it could hurt to ask why she isn’t doing it while she is in there.
My doctor ordered the ultrasound first as it shows how thick the vaginal lining is and if there are any abnormalities. The hysteroscopy inserts a camera into the uterus and an instrument is used to grab samples of the lining for biopsy, or removal of fibroids if they showed up on the ultrasound. A D&C would be more thorough because it removes any remaining tissue to ensure the entire lining is biopsied. I wanted both procedures done to be the most thorough.
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1 ReactionSome doctors think the hysteroscopy is adequate but will do a D&C if you request. That is what happened in my case. Timing may also be an issue as the D&C is a hospital procedure so it might take longer to schedule.
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1 ReactionYes mine was in a surgical center. My uterus showed slight thickening and she was already doing the hysteroscopy so she decided to do both. I was put under.
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