Effectiveness of endometrial biopsy and diagnostic dilatation and curettage aiming adequate specimen collection for histopathology for the diagnosis of endometrial carcinoma in patients with abnormal vaginal bleeding.

Abstract

Objective: To compare the effectiveness of endometrial biopsy and diagnostic dilatation and curettage  (D&C) in terms of adequate specimen collection for histopathology for diagnosing endometrial carcinoma in patients with abnormal vaginal bleeding. Study Design: Randomized Controlled Trial. Setting: Department of Obstetrics & Gynecology, Bahawalpur Medical & Dental College, Bahawalpur. Period: October 2022 to March 2023. Material & Methods: A total of 172 peri and post-menopausal women with abnormal uterine bleeding of more than 6 months were analyzed. Randomization was 1:1 for biopsy group (n=86) and D&C group (n=86). Patients in biopsy group underwent biopsy endometrial sampling while those in D&C group underwent diagnostic D&C for endometrial sampling. In biopsy group pipelle suction curette was used to collect the specimen. In D&C group, procedures were done employing general anesthesia. Obtained samples were sent for histopathology examination. Results: In a total of 172 women, the mean duration of abnormal vaginal bleeding were 9.267±2.37 months and 9.174±2.33 months in in biopsy and D&C groups respectively. Adequate specimen collection was noted in 93% women in biopsy group as compare to 97.7% in D&C group (p=0.147). Conclusion: Diagnostic dilatation and curettage as well as endometrial biopsy were effective in terms of adequate specimen collection for histopathology. Endometrial sampling using Pipelle was safe and accurate procedure conducted in outpatient department that avoided general anesthesia.