Comparison of Pipelle and Hysteroscopy with D&C in Postmenopausal Patients

Abstract

Objective: The aim of the study is to compare the pipelle method and hysteroscopy with D&C in postmenopausal patients Methods: In this prospective study, only those postmenopausal patients with postmenopausal bleeding and/or with a sonographically highly developed endometrium who were referred for hysteroscopy with D&C were included. A total of 92 patients were included in this study. Before each procedure, patients were explicitly informed about the study and gave consent. On the condition of anonymity of personal data (surname and first name, date of birth) and after signing a special informed consent form, the patients were allowed to be included in the study. The study was performed as a double-blind study. The obtained histologies (from pipelle and D&C) were sent separately to the same pathologist. Results: The group with malignant and premalignant findings has a central role in our study. After evaluation of the histologically malignant findings from the pipelle and the D&C, the sensitivity of the pipelle in our study was 82%. Conclusion: Endometrial biopsy is an important step to exclude endometrial carcinoma in postmenopausal bleeding. The aim is to minimize the burden and invasiveness of the procedure while maintaining a high degree of diagnostic certainty to avoid unnecessary invasive surgery. The pipelle sampling can be used as an outpatient method without anaesthesia during routine examination. Our study shows that this method of sampling is a safe, accurate and cost-effective outpatient procedure with high sensitivity for the detection of endometrial carcinoma.