Abstract
Objective: To compare the safety and efficacy of Improvised S2Q manual vacuum aspiration and Pipelle sampling as a diagnostic procedure for the evaluation of women presenting with abnormal uterine bleeding.
 Study Design: Quasi-experimental study.
 Place and Duration of Study: Department of Obstetrics and Gynecology, Combined Military Hospital, Lahore Pakistan, from Oct 2021 to Aug 2022.
 Methodology: A total of 148 females over 35 years of age with abnormal uterine bleeding, who needed endometrial sampling, were divided into two groups of 74 participants each. Group-A underwent endometrial sampling by Improvised S2Q manual vacuum aspiration, while Group-B underwent endometrial sampling by Pipelle sampler.
 Results: Mean age of patients was 47.36±8.34 years in Group-A and 48.20±8.96 years in Group-B, while the mean BMI was 30.59±4.67 kg/m2 and 27.39±2.50 kg/m2 in Groups A and B, respectively. The volume of specimen obtained was found to be higher in the Improvised S2Q manual vacuum aspiration-Group as compared to the pipeline sampling-Group. The operating time in the Improvised S2Q manual vacuum aspiration-Group was 3.37±0.49 minutes, while in the pipeline sampling-Group, it was 3.20±0.55 minutes. No difference was found in the two procedures for side effects (tachycardia, pain/cramps) and complications (significant blood loss, perforation, infection), added analgesia or histopathology report.
 Conclusion: Improvised S2Q manual vacuum aspiration can be used as an alternative low-cost procedure for endometrial sampling in women with abnormal uterine bleeding.Keywords: Biopsy, Curettage, Endometrium, Manual vacuum aspiration, Pipeline sampling.
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