Chapter 8 ■ PRACTICAL APPLICATIONS 175
Chapter Eight
PRACTICAL APPLICATIONS
Name: ______________________________
Operative Report
Preoperative diagnosis: Menorrhagia, leiomyomata
Anesthetic: General
Material forwarded to laboratory A. Endocervical curettings
for examination: B. Endometrial curettings
Operation Performed: Dilation and Curettage of the Uterus
With the patient in the dorsal lithotomy position (legs are flexed on the thighs, thighs flexed on the abdomen
and abducted) and sterilely prepped and draped, manual examination of the uterus revealed it to be 6- to
8-week size, retroflexed; no adnexal masses noted. The anterior lip of the cervix was then grasped with a
tenaculum (hook-like surgical instrument for grasping and holding parts). The cervix was dilated up to a #20
Hank dilator. The uterus was sounded (widened) up to 4 inches. A sharp curettage of the endocervix showed
only a scant amount of tissue. With a sharp curettage, the uterus was curetted in a clockwise fashion with an
irregularity noted in the posterior floor. A large amount of hyperplastic endometrial tissue was removed. The
patient tolerated the procedure well.
Operative diagnosis: Leiomyomata uteri
1. The preoperative diagnosis
indicated: …………………………………….
A. Excessive bleeding between menstrual
periods
B. Possibility of malignancy in the uterine
lining
C. Fibroids and excessive bleeding during
menstruation
D. Pelvic inflammatory disease
2. The operation described is: ……………..
A. Scraping and burning the lining of the
uterus
B. Surgical removal of a malignant tumor
C. Freezing and aspirating tissue from the
cervix and uterus
D. Widening the cervix and scraping the
lining of the uterus
3. What materials were sent to the
laboratory for analysis? …………………..
A. Tissue samples from vaginal and perineal
region
B. Cervical and uterine tissue samples
C. Ovarian and abdominal tissue
D. Uterine and ovarian tissue
4. What were characteristics of the
uterus upon examination by hand? ……
A. Bent forward and prepregnancy size
B. Bent backward and early pregnancy size
C. Narrowed and bent forward
D. Filled with hyperplastic tissue
5. An adnexal mass would be located
in the: …………………………………………
A. Uterus
B. Vagina
C. Cervix
D. Ovaries and/or fallopian tubes
6. The diagnosis following the operative
procedure indicated: ………………………
A. Endometriosis
B. Endocervicitis and endometritis
C. Benign growths in the uterus
D. Malignant fibroid tumors