role of endobrush in diagnosis of endometrial pathology in perimenopausal uterine bleeding

ABSTRACT

The value of the Endobrush endometrial cell sampling device in the cytological assessment of the endometrium was compared with dilatation and curettage. 100 women presenting with perimenopausal uterine bleeding were studied by both endometrial cytology and histopathology. The Endobrush sampling procedure caused no pain in 94% and slight pain in 6%. There was no incidence of failed insertion among the 100 cases examined. None of the women developed complications from the use of the instrument. The smears yielded specimens with abundant cells in 76% and moderate number of cells in 24%. None of the smears were acellular. In the 100 patients, 6 [6%] had a histopathological diagnosis of endometrial adenocarcinoma, and 78 [78%] had a histopathological diagnosis of endometrial hyperplasia. The cytology samples obtained with this device were diagnostic of endometrial adenocarcinoma in 5 [83.3%] of these 6 patients and 66 [84.6%] of the patients with endometrial hyperplasia. To lower these false negative results, the combination of office sampling with vaginal ultrasonography is proposed. A negative sampling in the presence of a thickened sonographic endometrial lining warrants additional investigation. The Endobrush cytology sampler is considered a safe and effective screening tool for endometrial adenocarcinoma and hyperplasia. The method is simple, quick and painless and therefore well acceptable to patients and suitable for clinical use