Pipelle endometrial sampling versus conventional dilatation & curettage in patients with abnormal uterine bleeding

Abstract

To compare the diagnostic accuracy of Pipelle endometrial sampling with conventional dilatation & curettage in patients with abnormal uterine bleeding. One hundred and forty patients with abnormal uterine bleeding were included in this comparative study; endometrial sampling was done before cervical dilatation by Pipelle device followed by conventional dilatation & curettage (D&C). The histopathology report of the Pipelle sample was compared with that of the D&C sample and the D&C report was considered as the gold standard. 100% of the samples obtained by conventional D&C, while 97.9% of the samples obtained by Pipelle device were adequate for histopathological examination. The histolopathological examination of one hundred and forty (140) samples obtained by conventional D&C revealed proliferative endometrium in 37 specimens, secretory endometrium in 33 specimens, endometrial hyperplasia in 49 specimens (45 without atypia & 4 with atypia), endometritis in 8 specimens, endometrial polyps in 3 specimens and malignant endometrium in 10 specimens. In this study; the Pipelle device had 100% sensitivity, 100% specificity and 100% accuracy for diagnosing endometrial hyperplasia, endometrial carcinoma, proliferative and secretory endometrium, also, it had 88.9% sensitivity, 99.2% NPV and 99.3% accuracy for diagnosing endometritis and it had 60% sensitivity, 89.6% NPV and 98.6% accuracy for diagnosing endometrial polyps. The endometrial sampling using Pipelle is safe, accurate, cost effective outpatient procedure, avoids general anesthesia with high sensitivity and specificity for detection of endometrial hyperplasia and endometrial malignancy.