Ibrahim Anwar Abdelazim1, Amro Aboelezz2, Amr Fathy Abdulkareem1. 1. Department of Obstetrics and Gynecology, Ain Shams University Maternity Hospital, Faculty of Medicine, Ain Shams University, Cairo, Egypt ; Department of Obstetrics and Gynecology, Ahmadi Hospital, Ahmadi, Kuwait. 2. Department of Obstetrics and Gynecology, Al-azhar University Maternity Hospital, Faculty of Medicine, Al-azhar University, Cairo, Egypt ; Department of Obstetrics and Gynecology, Ahmadi Hospital, Ahmadi, Kuwait.
Abstract
OBJECTIVE: This study was designed to compare the diagnostic accuracy of Pipelle endometrial sampling with conventional dilatation & curettage in patients with abnormal uterine bleeding. MATERIAL AND METHODS: One hundred and forty patients with abnormal uterine bleeding were included in this comparative study; where endometrial sampling was carried out 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 dilatation & curettage sample and the dilatation & curettage reports were considered as the gold standard. RESULTS: 100% of the samples obtained by conventional D&C, while 97.9% of the samples obtained by the Pipelle device were adequate for histopathological examination. The histolopathological examination of 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, and 99.2% negative predictive value (NPV) and 99.3% accuracy for diagnosing endometritis and it had 60% sensitivity, 89.6% NPV and 98.6% accuracy for diagnosing endometrial polyps. CONCLUSION: The endometrial sampling using Pipelle is a safe, accurate, cost effective outpatient procedure, which avoids general anesthesia and has a high sensitivity and specificity for detection of endometrial hyperplasia and endometrial malignancy.
OBJECTIVE: This study was designed to compare the diagnostic accuracy of Pipelle endometrial sampling with conventional dilatation & curettage in patients with abnormal uterine bleeding. MATERIAL AND METHODS: One hundred and forty patients with abnormal uterine bleeding were included in this comparative study; where endometrial sampling was carried out 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 dilatation & curettage sample and the dilatation & curettage reports were considered as the gold standard. RESULTS: 100% of the samples obtained by conventional D&C, while 97.9% of the samples obtained by the Pipelle device were adequate for histopathological examination. The histolopathological examination of 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, and 99.2% negative predictive value (NPV) and 99.3% accuracy for diagnosing endometritis and it had 60% sensitivity, 89.6% NPV and 98.6% accuracy for diagnosing endometrial polyps. CONCLUSION: The endometrial sampling using Pipelle is a safe, accurate, cost effective outpatient procedure, which avoids general anesthesia and has a high sensitivity and specificity for detection of endometrial hyperplasia and endometrial malignancy.
Authors: T Van den Bosch; D Van Schoubroeck; E Domali; I Vergote; P Moerman; F Amant; D Timmerman Journal: Ultrasound Obstet Gynecol Date: 2007-06 Impact factor: 7.299
Authors: Gloria S Huang; Juliana S Gebb; Mark H Einstein; Shohreh Shahabi; Akiva P Novetsky; Gary L Goldberg Journal: Am J Obstet Gynecol Date: 2007-03 Impact factor: 8.661