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Background: The aim of this study is to compare the accuracy and adequacy of endometrial sampling using pipelle biopsy with dilatation and uterine curettage (D and C) and hysterectomy specimen in the assessment of endometrium in patients of perimenopausal and postmenopausal age.Methods: One hundred fifty patients of perimenopausal and postmenopausal age who attended the Gynecology OPD of KIMS Hospital from June 2012 to May 2014 with complaints of abnormal uterine bleeding or who were found to have abnormally thickened endometrium by ultrasonography were included in the study.Results: Adequate specimen could be obtained through pipelle biopsy in 86.7% of the patients, compared to 76% with adequate sample in case of D and C. Comparing histopathology reports between Pipelle and DandC specimens, the confidence interval was 92.7%, 95% lying in the range between 86.54% to 96.53%. 68 of the 150 patients had undergone hysterectomy for various reasons. Comparing histopathology reports between Pipelle and hysterectomy specimens, the confidence interval was 94.2%; 95% of study population lies within the C.I range of 84.05 %-98.79% while accounting for the whole population, which shows that Pipelle endometrial sampling can be considered to be almost accurate as HPE by hysterectomy specimen. Comparing the difficulty of the procedure, Pipelle biopsy was found to be easier in perimenopausal patients when compared to post-menopausal patients and the difference was statistically significant. Mode of delivery did not seem to affect the ease of Pipelle endometrial sampling as per present observations.Conclusions: Endometrial tissue sampling using Pipelle was found to be as reliable as D and C and hysterectomy specimen on histopathologic examination for the assessment of endometrium in perimenopausal and post-menopausal age group. Pipelle endometrial sampling was found to be yield adequate specimen when compared with D and C.

Background: The aim of the study was to evaluate the factors affecting recurrence and prognosis in patients with borderline ovarian tumours and to assess the fertility outcome in women treated with conservative surgery.Methods: Fifty-six patients diagnosed with borderline ovarian tumours during the period between January 2005 and December 2009 in Regional Cancer Centre (RCC), Thiruvananthapuram were included. Patients were followed till December 2012.Results: Median follow up period was 52.5 months. The mean age at diagnosis was 33.5 yrs. Histopathology was serous in 41.1%, mucinous in 57.1%, and endometrioid in 1.8%. 48 patients (85.7%) had stage I disease, 2 patients (3.6%) had Stage II disease and 6 patients (10.7%) had stage III disease at diagnosis. 11 patients (19.6%) had bilateral tumours of which 7(63.6%) were serous and 4 were mucinous. 27 patients (48.2%) underwent fertility sparing surgery of which 13 patients underwent cystectomy and 14 underwent ovariotomy. 29 patients (51.78 %) underwent complete surgery including hysterectomy, bilateral salpingo oopherectomy and omentectomy. 14.3% of patients had microinvasive disease and 14.3 % had micro papillary disease on histopathology. 9 patients (16.1 %) had peritoneal implants of which 1 was invasive and 8 were non-invasive. Recurrence rate in the entire study group was 30.4%, 14.28% among patients undergoing complete surgery, 28.57% among patients undergoing adnexectomy and 69.2% among patients undergoing cystectomy.Conclusions: Univariate analysis showed a significant association between micropapillary histology, peritoneal implants and recurrence. On multivariate analysis, only peritoneal implants were found to be independently associated with recurrence.