Efficacy of pipelle endometrial sampling in diagnosing endometrial pathologies in postmenopausal women with asymptomatic thick endometrium in comparison to fractional curettage

Ahmed F. Sherif; Amr A. Awd

doi:10.53730/ijhs.v5nS1.14412

Authors

Ahmed F. Sherif
a_fathi_2013@yahoo.com
Obstetrics and Gynecology Department, Faculty of Medicine, Benha University, Benha, Egypt
Amr A. Awd Gynecology and Obstetrics Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt

Keywords:

pipelle endometrial sampling, fractional curettage, postmenopausal women, endometrial hyperplasia, endometrial carcinoma

Abstract

Objective: To evaluate the efficacy of pipelle endometrial sampling (PES) in diagnosing endometrial pathologies in patients with asymptomatic thick endometrium compared to fractional curettage (FC). Methods: A prospective, comparative, observational study was conducted, involving 100 postmenopausal women with asymptomatic thickened endometrium. Demographic characteristics, clinical features, and transvaginal ultrasound measurements were recorded. PES was performed as an outpatient procedure, followed by confirmatory FC under general anesthesia. Histopathological examination was conducted for both PES and FC samples. Diagnostic accuracy, pain scores, and association with endometrial hyperplasia and carcinoma were assessed. Results: The mean age of the participants was 56.7±2.8 years, with a mean body mass index of 29.6±3.6 kg/m2. The mean endometrial thickness was 14.3±2.9 mm. PES yielded 73 (73%) adequate samples, while FC yielded 87 (87%) adequate samples. Pain scores were significantly lower for PES compared to FC (3.23±1.23 vs. 6.48±1.54, respectively, p < 0.001). PES demonstrated a sensitivity rate of 81.25% and a specificity rate of 100% for endometrial hyperplasia, and a sensitivity rate of 60% and specificity rate of 100% for endometrial carcinoma. Conclusions: Pipelle endometrial sampling is an effective and well-tolerated method for diagnosing endometrial pathologies in postmenopausal women with asymptomatic thickened endometrium.

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References

Famuyide AO, Breitkopf DM, Hopkins MR, et al. Asymptomatic thickened endometrium in postmenopausal women: malignancy risk. J Minim Invasive Gynecol 2014;21(5):782-6, doi:10.1016/j.jmig.2014.03.004

Abd-Elmageed AA-E, abdo a, el beheidy tm, et al. Office Hysteroscopy and Pipelle Endometrial Biopsy versus Diltation and Curettage in Diagnosis of Endometrial pathology in women with perimenopausal bleeding. Zagazig University Medical Journal 2020;26(6):981-989, doi:10.21608/zumj.2019.15285.1371

Terzic MM, Aimagambetova G, Terzic S, et al. Current role of Pipelle endometrial sampling in early diagnosis of endometrial cancer. Transl Cancer Res 2020;9(12):7716-7724, doi:10.21037/tcr.2020.04.20

Tumrongkunagon S, Suknikhom W. Histological Sampling of Endometrial Tissue: Comparison between the MedGyn® Endosampler and Formal Fractional Curettage in Patients with Abnormal Uterine Bleeding. Asian Pac J Cancer Prev 2019;20(11):3527-3531, doi:10.31557/apjcp.2019.20.11.3527

Sanam M, Majid MM. Comparison the Diagnostic Value of Dilatation and Curettage Versus Endometrial Biopsy by Pipelle--a Clinical Trial. Asian Pac J Cancer Prev 2015;16(12):4971-5, doi:10.7314/apjcp.2015.16.12.4971

Behnamfar F, Arshad E. Diagnostic Values of Pipelle and Standard Curettage Compared to Hysterectomy Pathology in Postmenopausal Bleeding: A Comparative Study. Adv Biomed Res 2020;9(58, doi:10.4103/abr.abr_28_20

Giannacopoulos C, Karakitsos P, Stergiou E, et al. The use of Uterobrush and Pipelle endometrial samplers in diagnosis of endometrial pathology. European Journal of Gynaecological Oncology 1996;17(5):451-452

Demirkiran F, Yavuz E, Erenel H, et al. Which is the best technique for endometrial sampling? Aspiration (pipelle) versus dilatation and curettage (D&C). Arch Gynecol Obstet 2012;286(5):1277-82, doi:10.1007/s00404-012-2438-8

Ferry J, Farnsworth A, Webster M, et al. The efficacy of the pipelle endometrial biopsy in detecting endometrial carcinoma. Aust N Z J Obstet Gynaecol 1993;33(1):76-8, doi:10.1111/j.1479-828x.1993.tb02060.x

Bunyavejchevin S, Triratanachat S, Kankeow K, et al. Pipelle versus fractional curettage for the endometrial sampling in postmenopausal women. J Med Assoc Thai 2001;84 Suppl 1(S326-30

Yasmin F, Farrukh R, Kamal F. Efficacy of pipelle as a tool for endometrial biopsy. Biomedica 2007;23(July-December):116-119

Ilavarasi CR, Jyothi GS, Alva NK. Study of the Efficacy of Pipelle Biopsy Technique to Diagnose Endometrial Diseases in Abnormal Uterine Bleeding. J Midlife Health 2019;10(2):75-80, doi:10.4103/jmh.JMH_109_18

Abdelazim IA, Aboelezz A, Abdulkareem AF. Pipelle endometrial sampling versus conventional dilatation & curettage in patients with abnormal uterine bleeding. J Turk Ger Gynecol Assoc 2013;14(1):1-5, doi:10.5152/jtgga.2013.01

Dijkhuizen FP, Mol BW, Brölmann HA, et al. The accuracy of endometrial sampling in the diagnosis of patients with endometrial carcinoma and hyperplasia: a meta-analysis. Cancer 2000;89(8):1765-72

Kazandi M, Okmen F, Ergenoglu AM, et al. Comparison of the success of histopathological diagnosis with dilatation-curettage and Pipelle endometrial sampling. J Obstet Gynaecol 2012;32(8):790-4, doi:10.3109/01443615.2012.719944

Gungorduk K, Asicioglu O, Ertas IE, et al. Comparison of the histopathological diagnoses of preoperative dilatation and curettage and Pipelle biopsy. Eur J Gynaecol Oncol 2014;35(5):539-43