Accuracy of pipelle endometrial sampler in evaluation of endometrium

ABSTRACT

The purpose of this study was to compare the use of pipelle endometrial sampling device based on the quality of material obtained and diagnostic accuracy with conventional dilation and curettage [Dand C] or hysterectomy specimens. This cross sectional study was done on 50 patients who referred to gynecology ward of Imam Reza hospital with abnormal uterine bleeding [AUB] or infertility for endometrial dating. Thirty-eight patients underwent two endometrial samplings [pipelle and conventional D and C] on the same occasion while 12 cases underwent hysterectomy. The procedure of sampling by pipelle was done by one person and the specimens were submitted to a pathologist. The adequacy of the specimen and histoiogical diagnosis were compared. Pipelle obtained adequate sample in 47 of 50 cases [94%]. The histoiogical diagnosis was the same in 85% of cases [40 out of 47]. The sensitivity for endometrial dating and endometrial polyp was 100% and 40%, respectively. Among 7 cases of inconsistent diagnosis, there was one missed malignancy [squamous cell carcinoma of cervix with extension to isthmus and lower segment]. In this case the histoiogical diagnosis of pipelle was inactive endometrium surrounded by pieces of clot. Pipelle endometrial sampling is an easy method for diagnosis of endometrial pathology. Its diagnostic accuracy for endometrial dating is very high, but in management of AUB, replacing conventional D and C with pipelle should be done with caution and preferably completed by other diagnostic techniques