In last month’s “Change the Cycle” blog, we learned about the D&C (dilation and curettage) procedure. We discussed what it is, why it’s used, and touched on the difference between a visual D&C versus blind D&C. You may want to take a few minutes to review what we covered—or, if you missed it, this is a great time to get up to speed—just click here!
This month, in part two of our series on the D&C procedure, we want to dive a bit deeper into visual D&C and give you the information you need to talk to your doctor about whether it’s the right option for you.
Visual D&C versus blind D&C
As we learned last month in part one, a visual D&C means that your doctor removes unwanted tissue from your uterus while using a thin, light hysteroscope that transmits the image of your uterine lining, the endometrium, onto a screen. This allows your doctor to see the inside of your uterus as they remove tissue from it. With a blind D&C, your doctor can’t see the inside of your uterus as they remove tissue from it.
The leading OBGYN society, the American College of Obstetricians and Gynecologists (ACOG), recommends visual D&C: “If a (physician decides a) surgical approach is favored, D&C with hysteroscopic guidance is recommended over (blind) D&C alone because it has higher accuracy and superior diagnostic yield.”1 That sounds a little confusing, but what it means is if you have to have surgery to diagnose or treat your symptoms, the ACOG recommends visual D&C over blind D&C so the surgeon can see what uterine tissue they are removing.
Visual D&C with a tissue removal device
The MyoSure® tissue removal system is a tissue removal device that your doctor can use for a visual D&C. During the MyoSure procedure, your doctor can remove unwanted tissue under visualization and without having to remove or even cut the uterus. With this system, your doctor inserts the MyoSure hysteroscope through your cervix, allowing your doctor to see the endometrial tissue inside your uterus to locate anything abnormal. Then the MyoSure tissue removal device is inserted through the hysteroscope and is used to remove the tissue that may be causing your abnormal bleeding. This quick 20-second video shows you how it works:
Why is visualization important? Because adequate tissue samples are needed to diagnose endometrial abnormalities. If the tissue that’s removed isn’t intact or if there isn’t enough tissue to analyze, your doctor may not have enough information to know if there is an abnormality that could require treatment. If your procedure results in an inadequate tissue sample, your doctor may recommend additional follow-up or procedures.
Is visual D&C with a tissue removal device right for you?
The first step is talking to your doctor to ask their opinion on your individual situation. For example, women with heavy or long-lasting periods caused by fibroids or polyps may be candidates for the MyoSure procedure. Plus, the MyoSure procedure leaves your uterus intact, preserving your chances for having children in the future.
Women who are at high risk for endometrial cancer due to factors such as age, obesity, diabetes, and history of hyperplasia (thickening of the lining of the uterus)2 may also benefit from visual D&C with a tissue removal device.
Often, women are informed that a D&C has been ordered, and then they arrive at the appointment for the procedure with very few questions asked.
Remember that this is your care, and you have a say! Call your doctor before the procedure. Ask questions about the procedure and the type of D&C that will be performed. If you would prefer a visual D&C with a tissue removal device, ask if it’s offered—and if not, don’t simply accept that a blind D&C is your only choice.
Really, it’s OK to ask questions! Chances are that your doctor will appreciate that you’re invested in your health and taking an active role in your own care.
Want to learn more about the MyoSure tissue removal system? Visit this page for more information or download a brochure.
References:
- The American College of Obstetricians and Gynecologists (ACOG). Practice bulletin no. 149: endometrial cancer. Obstet Gynecol. 2015;125(4):1006-1026.
- American Cancer Society. Endometrial cancer risk factors. https://www.cancer.org/cancer/endometrial-cancer/causes-risks-prevention/risk-factors.html. Accessed October 11, 2022.
Important Safety Information
MyoSure tissue removal system is intended to remove unwanted tissue from the uterus. During a MyoSure procedure, a trained gynecologist inserts the MyoSure device through your vagina and then removes the unwanted tissue from inside the uterus. Use of the MyoSure system is not appropriate for patients who are or may be pregnant, or have signs or symptoms of a pelvic infection, cervical cancer, or previously diagnosed uterine cancer. As with any surgical procedure, there are potential risks including but not limited to internal injury, excessive bleeding, and complications related to anesthesia. Temporary side effects may include cramping, bleeding, fever, and nausea. This information is not medical advice. Please discuss the risks and benefits with your doctor to find out if the MyoSure procedure may be right for you.