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Comparison of aspirating pipettes and hysteroscopy with curettage

Archives of Gynecology and Obstetrics volume 301, pages 1485–1492 (2020)Cite this article

Abstract

Purpose

In this prospective study, endometrial biopsy by pipette was compared with hysteroscopy with curettage in patients with an abnormal uterine bleeding (ABU) (hypermenorrhea, intermediate bleeding, continuous bleeding, postmenopausal bleeding) and patients with a sonographically abnormal endometrium.

Methods

176 patients were included. The pipette samples were taken during the usual planned procedure under general anaesthesia. Thereafter, the planned hysteroscopy with curettage was completed. The study was performed as a double-blind study. The obtained histologies (of pipelle and curettage) were sent separately to the same pathologist. The pipelle material was encoded by a specific number without any patient data.

Results

In 97% of the cases using the biopsy with pipette were obtained an adequate sample. The biopsy with pipette had a sensitivity and specificity of 100% in the diagnosis of endometrial carcinoma and atypical hyperplasia. Pipette showed a significantly lower accuracy with a sensitivity of 28% in the diagnosis of endometrial hyperplasia without atypia. Pipette showed the lowest sensitivity for polyps, myomas and atrophic endometrium.

Conclusion

The study shows that pipette sampling is a safe, accurate, low-cost ambulatory procedure with high sensitivity for the detection of atypical endometrial hyperplasia and endometrial carcinoma. In the case of sonographically definable findings (polyp, myoma), hysteroscopy with curettage is preferred.

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Author information

Authors and Affiliations

  1. Clinic for Gynecology and Obstetrics of the Evangelical Hospital Cologne Weyertal Academic Teaching Hospital of the University of Cologne, Cologne, Germany

    E. Piriyev & T. Römer

  2. Practice for Pathology and Cytology Cologne Weyertal, Cologne, Germany

    W. Mellin

Authors
  1. E. Piriyev
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  2. W. Mellin
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  3. T. Römer
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Contributions

EP manuscript writing, data management, data analysis. WM analysis of the histology. TR project development and administration.

Corresponding author

Correspondence to E. Piriyev.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All patients have been explicitly informed and the intervention took place after the patient's written consent, as part of the planned hysteroscopy with curettage. This study was carried out in consensus with our university´s ethics guidelines.

Informed consent

Each patient was informed about the study. Written consent from the patient was a prerequisite for this study.

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Piriyev, E., Mellin, W. & Römer, T. Comparison of aspirating pipettes and hysteroscopy with curettage. Arch Gynecol Obstet 301, 1485–1492 (2020). https://doi.org/10.1007/s00404-020-05551-0

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  • DOI: https://doi.org/10.1007/s00404-020-05551-0

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