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D&C/Hysteroscopy Questions

Posts: 6
Joined: Aug 2018

I really appreciated the advice of this board's members.  I decided to go through the uterine biopsy and hysterogram, rather than going straight to a D&C and hysteroscopy.  A polyp was found and the biopsy results were benign, so the next step is a D&C and operative hysteroscopy. I am still mulling over the following:

1.  Given my family's history of uterine cancer, should I have a gynecological oncologist do the D&C and hysteroscopy?  Should I be looking at a big cancer center or is that not really an issue yet? I'm in the Washington, D.C. area.

2.  If some of the abnormal growth is due to perimenopause, can an endocrinologist help with the regulation of hormones?

3.  Is it possible to do a hysteroscopy without inflating the uterus with saline water, which may or may not contribute to the dissemination of cancer cells?

I would be grateful for any feedback!




NoTimeForCancer's picture
Posts: 2915
Joined: Mar 2013

PigletsMD, I saw no one answered, so I wanted to chime in.  A D&C is really a simple procedure and a gyn is qualified to do it.  Maybe the other ladies have had differently, but a gyn is certainly qualified to perform the D&C. 

Some uterine cancers can be effectively treated with hormones while others cannot, as hormones would "feed" the cancer.  They gyn onc will know which ones can/can't but always push for answers. 

I'm sorry, I have no insight on your third question.  Perhaps one of the other ladies have some knowledge.  

I realize with your family history of uterine cancer your worries, but it sounds like you are getting everything you need to get some answers.  Pleae let us know how you are doing. 

Posts: 111
Joined: Jan 2018

PigletMD - sorry you are here.  If they didn't find cancer with the biopsy the chances are that you are clear.  The D&C and Hysterscopy do not require gas.  I live in the DC area and my provider is Kaiser Permanente.  I was very happy with them during my health 'crisis'.  They provided videos for the D&C/Hysterscopy and Hysterectomy which I found very useful and answered alot of my questions.  There is gas involved in the Hysterectomy but not with the Hysterscopy.  Basically, they use a camera to see what they need to see and I don't think gas is needed.  They use gas for a colonoscopy because where they need to go is much more restrictiveSmile

Good luck to you!

NoTimeForCancer's picture
Posts: 2915
Joined: Mar 2013

thanks, MugsBugs.  I have to tell you ladies, my gyn first wanted to do an endometrial biopsy, since she ended up deciding it would be too much pain, my gyn didn't charge me and wanted to go directly to a D&C.  

Since Piglet opened this, I would love to discuss, if you ladies don't mind, about what you all have had and why.  I am happy with the tests I have in that order, but maybe one of you can tell me why you have had the hysteroscopy.  I found this link https://www.emedicinehealth.com/hysteroscopy/article_em.htm#hysteroscopy_overview and would love to hear what you all think.

Thank you in advance.

Posts: 111
Joined: Jan 2018

When I was diagnosed I thought my GP was being overly dramatic - she is very proactive about flu/pneumonia vaccines, mammograms, etc.  Things I would just prefer to ignore.  I was/am caring for my elderly parents and I had a back ache.  A few months before the back ache I noticed some spotting.  Since I couldn't afford any downtime because I made an appointment about my back.  I casually mentioned the spotting to my GP.  I was immediately sent the same day to the gyno (I have always avoided these appointments because I don't like to expose my lady parts).  He did a biopsy (ouch) that day.  From there things moved fairly quickly:


1.  Biopsy came back atypical. They also thought the endometrial was thick.  I have had fibroids for a long time.  They said they would shrink after menapause.

2.  Internal Sonogram.  It found the the fibroids but nothing to be concerned about.

3.  CA125 - it was 18 which gave me a sigh of relief because after reading this wasn't bad.  I had my six month check-up yesterday and my CA125 is 9 - yippee!

4.  D&C and Hysterscopy  (not as bad as I anticipated).  The doctor said she found some 'calcification'.  After this procedure it came back positive for endometrial cancer.  Met with the Gyn/Onc.

5.  CAT scan upper and lower with contrast (drinking for lower and IV for upper).  Found a mass in the colon (turned out to be diverticulosis - so nothing serious).

6.  Colonoscopy because of the mass found in CAT scan - they found a few polyps and diverticulosis.  Because of the polyps I am on the 5 year plan for colonoscopies.

7.  Finally full hysterectomy (again not as bad as I was anticipating).  Final diagnosis Grade 1, Stage 1.  In fact my gyno had scraped most of the cancer out during the D&C.  My gyno said yesterday that this isn't too unusal when they catch the cancer early.

Six months out I am feeling pretty darn lucky that my doctor was proactive because I could have gone on for years being oblivious - I noticed some symptoms but just thought it was normal aging.  I have been really pleased with the care that Kaiser Permanente has provided.  I lost 13 pounds after the surgery amd was happy.  Once I was feeling better I started gaining weight again which was a bummer so I started Weight Watchers (boring but effective) and am now down 35 lbs. since my initial diagnosis.   

Ladies don't ignore symptoms!


LisaPizza's picture
Posts: 343
Joined: Feb 2018

I went straight to hysteroscopy and D&C, I think because i had a prolapsing polyp that needed to be removed anyway, even if I didn't have cancer, because it was bleeding.

Armywife's picture
Posts: 452
Joined: Feb 2018

I had no symptoms at all except for a tiny spot of blood.  Went to my provider and she recommended a transvaginal ultrasound.  That looked abnormal, so I had a pipelle endometrial biopsy.  Revealed cancer so was scheduled 2 weeks later for robotic hysterectomy.  They were expecting stage I Grade 1 and what I had was Stage IVB Grade 2.

hopeful56's picture
Posts: 73
Joined: Jul 2017

Hi Pigslet MD,

Welcome to the site.  Sorry you have to be here but you have found a great place to support you in your journey.

My symptoms were just minimal spotting.  My internist immediately set me up for transvaginal ultrasound and a gyn/surgeon to go over results of test.  The gyn/surgeon did the hysteroscopy due to the thickness of my uterus.  She already had told me if if resulted in cancer, I would then see a surgeon/oncologist which was my path.  Hysteroscopy I was put out and procedure went quick, released same day.

My advice is just take one step at a tme, it can be overwhelming.

My best to you.



cmb's picture
Posts: 730
Joined: Jan 2018

I've had two incidents of post-menopausal spotting (2007 and 2016) and the preliminary steps were the same in both instances.

First, the doctors (gynecologist the first time and the PCP and a different gynecologist the second time) tried to do the in-office biopsy – none could be completed due to the pain I had on these attempts.

Second, I had a transvaginal ultrasound each time. Both times the ultrasound showed a thickening of the endometrial stripe, although this was more pronounced on the 2016 ultrasound.

Third, I had the D&C and Hysteroscopy under general anesthesia both times. I have no record if they used gas or saline solution during the hysteroscopy.

From here the process differed.

In 2007, the finding was a benign polyp and no further action was taken after it was removed during the D&C.

In 2016, I was diagnosed with uterine carcinosarcoma (MMMT) cancer. I then had a pre-surgery CT scan and bloodwork taken (including the CA125 test). I also had a colonoscopy just before the surgery at the request of my gynecological oncologist, since it has been some years since I had last had one (only a tiny polyp found).

I had surgery in December 2016 (Robotic assisted laparoscopic total hysterectomy with bilateral salpingo oophorectomy, pelvic and para aortic lymph node sampling, pelvic washings). Diagnosed as Stage 3B.

Surgery was followed by chemo and radiation in 2017.

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