Hysteroscopy and guided biopsy has been considered as gold standard for assessing the endometrium and detecting or ruling out endometrial cancer in current gynaecology practice but it carries risk of anaesthesia, perforation whereas, Pipelle sampling is safe, efficient, without use of anesthesia, and cost effective.
The objective of the study was to compare the histopathological findings with Pipelle endometrial sampling device, its reliability and predictive value, with histopathology on hysteroscopy guided biopsy.
Materials and Methods: A prospective cohort study evaluating the role of Pipelle aspiration as an outpatient procedure in endometrial sampling of women >18years with AUB. 50 women with clinical diagnosis of abnormal uterine bleeding were selected from the Gynaecology OPD of Kasturba hospital, Delhi. They were subjected to endometrial sampling by Pipelle followed by hysteroscopic-directed biopsy in premenstrual phase. The efficacy of Pipelle was determined by correlating the histopathological results obtained from it and the hysteroscopic-directed biopsy.
Results: The histopathology of the endometrium obtained using Pipelle’s curette has high specificity (100%) and positive predictive value (100%) for diagnosing endometrial pathology while sensitivity 25% and negative predictive value 76.32%.
Office endometrial biopsy by Pipelle sampling device should be the initial diagnostic procedure of choice due to its convenience, accuracy, availability, safety and low cost. Hysteroscopy should be reserved for triage of cases where a focal lesion, irregular or thick endometrium is suspected on sonography or symptoms persist despite treatment according to histopathology on endometrial aspiration biopsy.