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Evidence-Based Interventions: dilatation and curettage for heavy menstrual bleeding


>>Eddie Morris: My name’s Eddie Morris,
I’m vice president for the Clinical Quality at the Royal College of Obstetricians and
Gynaecologists and I’m here to talk about dilatation and curettage for the diagnosis
of heavy menstrual bleeding and why it’s being included as part of the NHS Evidence
Based Intervention programme. Dilatation and curettage is a process of gently
stretching the neck of the womb, the cervix, under general anaesthetic and then performing
a scarping of the lining of the womb for diagnostic and what was thought to be treatment processes
in the past. Dilatation and curettage has largely been
replaced over the past 20 years by a process known as hysteroscopy and biopsy, which is
frequently performed in the outpatient setting. The reason why this has been developed is
because modern optics and digital technology have allowed us to get much clearer pictures
of the inside of the womb, so we can easily visualise what’s going on within the womb
and sometimes actually treat at the same time. Because the technology to perform a hysteroscopy
is much smaller than it was when it first came out we’ve been able to now perform
these procedures in an outpatient setting, this has less impacts on the woman herself,
but also has a beneficial impact on the healthcare system in that these procedures can now be
done in the outpatient setting and now draw on the use of inpatient theatres.
Myself and my colleagues at the Royal College of Obstetricians and Gynaecologists strongly
support the inclusion of dilatation and curettage as part the NHS Evidence Based Intervention
programme. This allows us to ensure that patients receive the most appropriate and a procedure
with best outcomes to make sure that we concentrate the NHS resources where they are needed most.

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