Evaluation of endometrial biopsy using an aspiration curet without cervical tenaculum.

In a study of 132 women having endometrial biopsy with either a Novak or Randall aspiration curet before hysterectomy, a tenaculum was not used initially if the curet could be passed easily through the cervix. One biopsy specimen was taken from the anterior endometrium and one from the posterior endometrium. Biopsy was successful in 80 women (61%) and unsuccessful in 52 (39%). Women who are premenopausal, who do not have cervical stenosis, and who have a uterus that sounds to 3.5 inches or less are significantly more likely to have a successful biopsy. Excluding six women in whom the curet could not be passed through the cervix, adequate tissue for histologic evaluation was obtained in 101 of 126 women (80%). Furthermore, endometrial biopsy accurately reflected histopathologic features of the surgical specimen in 98% (98/101) of the women who had sufficient tissue obtained for evaluation. Endometrial biopsy done with an aspiration curet but without placing a tenaculum on the cervix should be attempted in women who require evaluation. Endometrial biopsy would appear to rival dilation and curettage for obtaining endometrial tissue that accurately reflects endometrial histopathology.

Comparison of cytobrush and cotton swab for Papanicolaou smears in pregnancy.

Papanicolaou smears obtained using cytobrush or cotton swabs were compared in 222 pregnant women. There were no complications attributable to the cytobrush. Endocervical cell yields obtained with the brush were 70.9% compared to 41.9% with the swab (P = .0001). There was no difference between use of the swab and the brush in the prevalence of dysplasia (19 cases) nor was there any difference in the prevalence of dysplasia in the smears that contained endocervical and/or metaplastic cells (17/181 = 8.6%) compared to those not containing these cell types (2/24 = 8.3%). This study suggests that use of the cytobrush in pregnancy warrants further study because of the frequency with which smears are reported as inadequate because they lack endocervical and/or metaplastic cells.