Evaluation of The Efficacy of Pipelle In Diagnosis of Endometrial Lesions in Cases of Perimenopausal Bleeding

Volume 4 - Issue 2

Nagy M Metwally Ahmed*

Received: December 02, 2020;   Published: January 27, 2020

DOI: 10.32474/IGWHC.2020.04.000182

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Abstract

One of the most common gynecologic complaint is irregular uterine bleeding It is one of the most common Problem in the perimenopausal and postmenopausal years. It has a direct impact on woman physical, social, emotional and material quality of life. While vaginal bleeding is the sign of endometrial cancer in more than 90% of postmenopausal women which is the sixth most common malignant neoplasm in women worldwide and is the most common gynecologic malignancy in developed countries, therefore, the diagnosis of AUB needs to be undertaken seriously. This study was implemented to evaluate the efficacy of suction pipelle-which is an endometrial sampling technique- in diagnosis of endometrial lesions in cases of abnormal uterine bleeding. It was designed as a cross sectional study and included 184 patients complaining of AUB. 2 samples were taken from all candidate women one by D&C and the other was by pipelle device and the results of histopathological examination of both were compared regarding that D&C was the gold standard. After statistical analysis of the present study by SPSS version 23 software, the 2 methods were 100% matched in diagnosis of secretory endometrium, hormone dependent endometrium, atypical hyperplasia and EEC grade 1. The pipelle succeeded to diagnose some cases of proliferative endometrial and simple hyperplasia which were missed by D&C (18.5% and 17.4% by pipelle versus 16.3% and 13% by D & C respectively). Unfortunately, there were cases the pipelle failed to diagnose, as in some cases of endometrial polyp and disordered endometrial hyperplasia which diagnosed by D&C (8.7% and 17.4% by pipelle versus 16.3% and 19.6% by D& C respectively).

Conclusion: Pipelle is an outpatient procedure which avoids general anesthesia and its related risks, does not need room or personnel in the operating theatre, is less painful, is more cost-effective and obtains an accurate specimen with consistent histopathology results compared to D&C. It would, however, have decreased sensitivity for endometrial polyp diagnosis and hyperplasia.

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