Publication:

Comparison of adequacy of endometrial biopsy using endosampler and hysteroscope guided sampling

Background The objective of the study was to compare the tissue adequacy of endometrial biopsy obtained using hysteroscope guided biopsy and endosampler for histopathology.

Methods This was a cross sectional study in the Department of Obstetrics and Gynaecology and Pathology, Medical College Hospital, New Delhi, India. Ninety patients fulfilling the inclusion criteria were subjected to office hysteroscope guided biopsy followed by endometrial aspiration biopsy using endosampler in the same sitting. Labelling of samples was done as ‘A’ and ‘B’ and sent for histopathological examination in 10% formalin. Pathologist was blinded to the type of biopsy taken and samples were evaluated for tissue adequacy. The presence of even one intact endometrial gland with stroma was labelled as adequate endometrial biopsy sample by the pathologist.

Results The endometrial biopsy samples obtained by both methods were adequate in 35 patients (38.89%). On the other hand, there were 18 patients (20%) who had inadequate sampling results by both methods. Out of the remaining 37 patients, in 13 (14.44%) patient’s endometrial biopsy was adequate by hysteroscope guided biopsy and in 24 (26.67%) patients it was adequate using endometrial aspiration   Individually, hysteroscope guided biopsies were found to have adequate results in 48 patients out of 90 (53.33%) while endosampler aspiration provided adequate biopsy results in 59 patients out of 90 (65.56%) after excluding the number of patients having inadequate reports. The difference between tissue adequacy of both devices was not statistically significant (p=0.129). A significant correlation was found between age (p<0.001), endometrial thickness on ultrasound (p<0.0001) and tissue adequacy by both methods.

Conclusions Endometrial biopsy obtained by hysteroscope guided method and endometrial aspiration was comparable in terms of tissue adequacy.