Pipelle Endometrial Sampling Versus Fractional Curettage for evaluating patient of Postmenopausal Bleeding: A Comparative Study

Evaluating Postmenopausal Bleeding

Authors

  • Salma Akhtar Walida Depertment of Gynae and Oncology National Institute of Cancer Research Hospital (NICRH) Mohakhali, Dhaka
  • Begum Rokeya Anwar Depertment of Gynae and Oncology, NICRH, Mohakhali, Dhaka
  • Shahjada Mohammad Dastegir Khan Neuromedicine, Sir Salimullah Medical College, Mitford, Dhaka.
  • Afroza Khanom Gynae and Obs, NICRH, Mohakhali, Dhaka
  • Chowdhury Shamima Sultana Gynae and Oncology, NICRH, Mohakhali, Dhaka
  • Nasrin Hossain Department of Gynae and Oncology, National Institute of Cancer Research & Hospital (NICRH), Mohakhali, Dhaka.
  • Mahenaz Afroz Department of Gynae and Obs, National Institute of Cancer Research & Hospital (NICRH), Mohakhali, Dhaka
  • Mst Farhana Tannum Khan Department of Gynae and Oncology, National Institute of Cancer Research & Hospital (NICRH), Mohakhali, Dhaka.
  • Humaira Haque Department of Gynae and Oncology, National Institute of Cancer Research & Hospital (NICRH), Mohakhali, Dhaka.

DOI:

https://doi.org/10.3329/bmrcb.v50i1.68852

Keywords:

Pipelle endometrial sampling, Fractional curettage, Postmenopausal bleeding, Endometrial cancer, Endometrial hyperplasia

Abstract

Background: Postmenopausal bleeding (PMB) is a common presentation in gynecological oncology outpatient department and it is most frequent complaints of endometrial cancer. 3-5,7 In Bangladesh, about one-third of patients visiting the gynecological oncology outpatient department with the complaints of PMB. Fractional Curettage (FC), the conventional diagnostic method, presents challenges due to invasiveness and cost. Pipelle endometrial sampling (PES) is a promising alternative that is less invasive, more convenient, and better tolerated.3 However, no study has been done in Bangladesh comparing the Pipelle endometrial sampling procedure with Fractional Curettage. This study aimed to fill this gap by comparing Pipelle endometrial sampling (PES) to FC in diagnosing PMB.

Objective: This study aimed to evaluate the diagnostic accuracy of Pipelle endometrial sampling compared to Fractional Curettage in PMB patients. Specific objectives included assessing the adequacy of sample collection for definitive endometrial disease diagnosis and comparing histopathological findings between Pipelle endometrial biopsy and Fractional Curettage materials.

Methods: An observational study involving 45 PMB patients was conducted at National Institute of Cancer Research and Hospital, Mohakhali, Dhaka from January to December 2022. Each patient underwent both PES and FC. Histopathological results were compared, and diagnostic accuracy, sensitivity, specificity, and predictive values for PES were calculated.

Results: PES demonstrated finally 43, 97.8% sample adequacy compared to FC’s 44, 100%. PES detected four cases of atypical endometrial hyperplasia, one polyp, and nine endometrial carcinoma cases, while FC found three atypical endometrial hyperplasia cases, two polyps, and ten endometrial carcinoma cases. PES exhibited 100% sensitivity, specificity, PPV, 97.72% NPV, and 97.72% diagnostic accuracy for most benign conditions. For polyps, sensitivity was 50%, specificity 100%, PPV 100%, NPV 97.72%, and diagnostic accuracy 97.72%. In endometrial carcinoma cases, sensitivity reached 90%, specificity 100%, PPV 100%, NPV 97.14%, and diagnostic accuracy 97.72%. Finally we have excluded 1 sample from our study group for statistical analysis.

Conclusions: PES offers a safe, accurate, cost-effective, and well-tolerated outpatient alternative for assessing endometrial pathology in PMB patients, it also preserve stromal architecture better. Its performance is comparable to FC in most of the condition, making it a valuable resource-efficient choice, especially in limited-resource settings.

Bangladesh Med Res Counc Bull 2024; 50: 4-9

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Published

2024-04-01

How to Cite

Walida , S. A., Anwar, B. R. ., Khan, S. M. D. ., Khanom , A. ., Sultana , C. S. ., Hossain, N., Afroz, M., Khan, M. F. T., & Haque, H. (2024). Pipelle Endometrial Sampling Versus Fractional Curettage for evaluating patient of Postmenopausal Bleeding: A Comparative Study: Evaluating Postmenopausal Bleeding. Bangladesh Medical Research Council Bulletin, 50(1), 4–9. https://doi.org/10.3329/bmrcb.v50i1.68852

Issue

Vol. 50 No. 1 (2024)

Section

Research Papers

License

Copyright (c) 2024 Salma Akhtar Walida ; Begum Rokeya Anwar, Shahjada Mohammad Dastegir Khan, Afroza Khanom , Chowdhury Shamima Sultana , Nasrin Hossain, Mahenaz Afroz, Mst. Farhana Tannum Khan, Humaira Haque

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