Abnormal Uterine Bleeding in Ten Minutes or Less

[ChangJitsen]

diagnostic hysteroscopy and endometrial cancer: two camps (no one is wrong, you will see attendings do both)

[ChangJitsen]

#1 Camp - if I have someone who has cervical stenosis and I can't get an EMB in the office, then I am going to do a "blind" D&C in the OR, because I'm afraid of "pushing" cancer cells into the periotoneal cavity (this has been proven to be true, as cited in the video) despite hysteroscopy/D&C being the gold standard

[ChangJitsen]

#2 Camp - a diagnostic hysteroscopy is the gold standard, thus i'm doing a visually directed biopsy, and I know what endometrial cancer looks like. But even if I push endometrial cancerous cells into the peritoneal cavity, it won't worsen prognosis, since the latest staging guidelines for endometrial cancer discovered positive "washings" didn't worsen prognosis.

[ChangJitsen]

(Now Gyn Oncology doesn't even do pelvic "washings" in an endometrial cancer case, unless there is an adnexal mass and the possibility of a synchronous ovarian malignancy)