Endometrial Pipelle sampling and D&C: a comparative study

Written by Toma Áron, Szabó Béla, Puşcaşiu Lucian, Chira Liliana, Căpîlna Mihai Emil, Kiss Szilárd-Leó, Szabó Kinga Erika

Introduction: The abnormal uterine bleeding in a nonpregnant patient is the most frequent cause of morbidity in the gynecologic pathology. The leading symptom in case of premalignant or malignant modifications of the endometrium is abnormal uterine bleeding; hence when there is suspicion for malignancy, exclusion - by sampling of the endometrium and histopathological examination - is mandatory. The classical method of endometrial biopsy is dilatation and curettage (D&C) but there have been developed other, newer and more advantageous methods. Objective: The aim of this study is to evaluate the diagnostic value of Pipelle endometrial biopsy in comparison with the “gold standard”, dilatation and curettage (D&C). Materials and methods: In this blind, prospective study 41 patients underwent Pipelle endometrial biopsy followed by D&C in the I. Obstetrics and Gynecology Clinic of Târgu Mureş. Results: By comparative analysis of these two methods based on the histopathological diagnoses, we obtained the following results: in 3 cases the Pipelle biopsy, and in one case the curettage didn’t obtain sufficient material for the histopathological examination. The histopathological results were identical in 25 cases (67.6%) out of 37. The biopsy material obtained by the Pipelle method was adequate as quality and quantity for diagnosing hyperplasia (5 cases) and neoplasia (3 cases) of the endometrium, results also confirmed on the material obtained by the D&C. Conclusions: The Pipelle biopsy is a useful, cost-effective method, convenient for doctor and patient, which has numerous advantages over the classical biopsy and which could have an important role in everyday practice as a first line biopsy method.

 

Keywords: Pipelle, minimal invasive, endometrium, biopsy.


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