Diagnostic approach to Perimenopausal bleeding by Pipelle or Dilatation and Curettage

Abstract

Perimenopausal bleeding, is a very common problem, which is an alarming symptom for both; women and their doctors because of the rising fears of cellular changes or tumor of endometrium. In our study we tried to prove that collecting endometrial samples using the outpatient method of Pipelle is as effective as collecting the endometrial samples in the traditional method of Dilation and Curettage (DandC) in operation theatre which necessitates general anesthesia. Ninety four patients more than 40 years old were included in the study, all of them were complaining of abnormal uterine bleeding (pregnant ladies and ladies using hormonal contraception were excluded from the study) and endometrial samples were collected first in outpatient clinic using the Pipelle and labelled as A samples and secondly in the theatre under general anesthesia by dilatation and curettage and labelled as B samples, all samples were sent for histopathology without informing the pathologist about the method of sample collection and patients past medical history. Then, the reports of histopathological examination were compared between Pipelle and DandC samples (group A and group B). From the results we can conclude that samples of endometrium using Pipelle could replace the traditional method of DandC, with high specificity and sensitivity in detecting endometrial carcinoma and endometrial hyperplasia.