Validity of pipelle endometrial sampling in patients with abnormal uterine bleeding

BACKGROUND AND OBJECTIVES: We compared endometrial sampling by pipe lle endometrial curette withconventional di latation and curettage (D C) in patients with abnorm al uterin e bleedin g.METHODS: Endometria l samplin g with pipelle curette was perform ed on 100 patients followed by forma l D CSamples were labeled asA and B, respectively, and sent to a histopathologist who was bli nded as to the methodof sampling. The histopatholo gy reports of both samples were compared, takin g D C as the gold standard.RESULTS: An adequate sample was obtain ed in 98% of cases by pipelle and in 100% of cases by D C Pipellehad a sensitivity, specifi city, posit ive predictive value and negative predi ctiv e value of 100% for diagnosingendometrial carcinoma, hyperplasia and secretory endometrium. Pipelle also had high diagnostic sensitivity,specific ity and negative predictive value (100%, 98% and 100%, respectiv ely) for hyperplasia with atypia, andlow sensitivity (57%) and positiv e predictive value (57%), but high specifi city (97%) and negative predictivevalue (97%) for endometritis . Simi larly, for pro liferative endometrium, the pipelle technique had values of 94%and 93% for sensitivity and specifi city, respectively. Both samples labeled as inadequate for histo logy by pipellewere polyps on the D C report. Difficu lt endotracheal intubation was encountered in two cases of D C Noother compli catio ns of the procedure were observed.CONCLUSION: The pip el le is a safe device for getting an adequate endometrial sample for histology, with ahigh sensitivity and specific ity for detection of hyperplasia and maligna ncy.