DefinePK

Research 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.

Methodology

Randomized Controlled Trial conducted at Bahawalpur Medical & Dental College, Bahawalpur, from October 2022 to March 2023. A total of 172 peri and post-menopausal women with abnormal uterine bleeding of more than 6 months were analyzed, randomized 1:1 into an endometrial biopsy group (n=86) using a Pipelle suction curette and a diagnostic D&C group (n=86) performed under general anesthesia. Obtained samples were sent for histopathology examination.

Methodology Flowchart

                        graph TD;
    A[Recruit 172 peri/post-menopausal women with abnormal uterine bleeding] --> B[Randomize 1:1];
    B --> C[Endometrial Biopsy Group n=86];
    B --> D[Diagnostic D&C Group n=86];
    C --> E[Collect specimen using Pipelle];
    D --> F[Perform D&C under general anesthesia];
    E --> G[Send biopsy sample for histopathology];
    F --> H[Send D&C sample for histopathology];
    G --> I[Analyze adequacy of specimen];
    H --> I;
    I --> J[Compare efficacy between groups];
    J --> K[Draw Conclusion];                    

Discussion

Endometrial biopsy is a safe and accurate outpatient procedure that avoids general anesthesia. While D&C showed a slightly higher rate of adequate specimen collection, endometrial biopsy with Pipelle is a viable and effective method for diagnosing endometrial carcinoma in patients with abnormal vaginal bleeding.

Key Findings

Adequate specimen collection was achieved in 93% of women in the endometrial biopsy group compared to 97.7% in the D&C group (p=0.147). Both procedures were effective in terms of adequate specimen collection for histopathology.

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 a safe and accurate procedure conducted in an outpatient department that avoided general anesthesia.

Fact Check

1. Sample Size: The study analyzed a total of 172 women, with 86 in the biopsy group and 86 in the D&C group.
2. Adequate Specimen Collection Rate (Biopsy Group): 93% of women in the biopsy group had adequate specimen collection.
3. Adequate Specimen Collection Rate (D&C Group): 97.7% of women in the D&C group had adequate specimen collection.

Mind Map