Objectives: Endometrial biopsy is necessary for diagnosing the reason of abnormal uterine bleeding in perimenopausal women. Currently outpatient endometrial biopsy is used for evaluation of abnormal uterine bleeding which is associated with moderate to severe pain. Using lidocaine is one of the procedures which is used for pain relief while biopsy. This study is aimed at comparing the effect of different local anesthesia procedures on pain relief during endometrial biopsy. Materials and Methods: In this randomized clinical trial, 160 multiparous 40-55 years old women with AUB (Abnormal Uterine Bleeding), candidates for endometrial biopsy, were randomly assigned into four equal groups, to receive: 1-intrauterine lidocaine; 2-cervical spray lidocaine; 3-intrauterine lidocaine plus cervical spray lidocaine; or 4-intrauterine distilled water. Pain relief was measured at 3 different times: during endometrial biopsy, just after and 15 minutes after biopsy. Results: Pain intensity was reduced significantly at different times in intrauterine lidocaine and intrauterine lidocaine with cervical spray lidocaine receivers in compare with the groups which received cervical spray lidocaine and distilled water. The mean of difference pain relief during biopsy and 15 minutes after that was reduced significantly in the group which received intrauterine lidocaine and intrauterine lidocaine with cervical spray lidocaine in comparison with the other two groups. Conclusion: Intrauterine lidocaine was effective during endometrial biopsy, and using it with cervical spray lidocaine had no more beneficial effect.

Ovarian cancer is the leading cause of gynecological malignancy-related mortality. CA125 level in patients with Epithelial Ovarian Cancer (EOC) and endometrioma can frequently be high. CA72-4 level was also elevated in several carcinomas including ovarian cancer. Due to its lack of specificity, however, this marker has a limited role in the differential diagnosis between EOC and endometrioma. In this research, we studied the levels of biomarkers CA125 and CA72-4 to determine their potential role in the differential diagnosis of endometrioma and EOC. For this goal, biomarkers CA125 and CA72-4 were identified in 75 patients with ovarian cancer and 75 patients with endometrioma. Cut-off levels for CA125 and CA72-4 were considered 35 U/ml and 3.8 U/ml, respectively. The data have been analyzed by SPSS, with a p-value<0.05 considered significant. Both markers CA125 and CA72-4 were remarkably elevated in EOC (p=0.001). Areas under the ROC curve for CA125 and CA72-4, with sensitivity of 0.48 and specificity of 0.52, were 0.633 and 0.624, respectively. The differences were not significant. It has been shown that CA125 and CA72-4 serum levels are elevated in patients with EOC; however, this did not lead to detection of malignancy. This means that CA72-4 level does not demonstrate a significant difference in malignancy diagnoses when compared to the use of CA125 alone.

No abstract