Comparison of cytospat and pipelle endometrial biopsy instruments.

OBJECTIVE

To compare two endometrial biopsy techniques, based on the quality of material obtained, cost effectiveness, and pain during the procedure.

STUDY

DESIGN

A single blind, randomized prospective study.

RESULTS

A total of 365 women with peri/postmenopausal bleeding were randomized into two groups: 174 biopsied cytospat (C) and 191 biopsied with pipelle (P). Both procedures were then followed by either dilatation and curettage (D&C) or hysterectomy. Pain was evaluated in 379 patients, with the result being better tolerance for P vs. C (3.55 vs. 4.06, P = 0.07). With C, the sensitivity in histological evaluation was 82% for benign endometrium, 60% for endometrial hyperplasia and 60% for corpus uterine neoplasia as compared to the D&C and hysterectomy material. With P the sensitivity was 84, 71 and 60%, respectively for the three diagnoses, as compared to the D&C and hysterectomy material. Insufficient tissue for pathologic evaluation was present in 24% of C, 25% of P and 9.8% of D&C samples.

CONCLUSIONS

Cost effectiveness for pipelle is slightly higher than for Cytospat.