Comparison of tissue adequacy for histologic examination from Ipas MVA plus and Wallach Endocell in women with abnormal uterine bleeding

Wanijasombutti, Paphada; Imruetaicharoenchok, Arinporn; Tangjitgamol, Siriwan; Loharamtaweethong, Kongsak; Phuriputt, Napaporn; Phaloprakarn, Chadakarn

doi:10.1111/jog.12693

Cited by 5 publications

(7 citation statements)

References 27 publications

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“…Previous studies have indicated that the performance of endometrial sampling is as good as those of dilatation and curettage (D&C) or manual vacuum aspiration. 4 , 5 In cases of postmenopausal bleeding, endometrial sampling has been shown to have a sensitivity of 90% and specificity of 99%–100% for diagnosing endometrial hyperplasia or endometrial cancer with D&C or hysteroscopy with biopsy as a reference standard. 6 A previous systematic review found moderate agreement with regard to tumor grade between endometrial sampling and final pathology from hysterectomy.…”

Section: Introductionmentioning

confidence: 99%

Incidence and risk factors for insufficient endometrial tissue from endometrial sampling

Aue-aungkul¹,

Kleebkaow²,

Kietpeerakool³

2018

IJWH

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ObjectiveTo assess the incidence of and factors that predict insufficient tissue after endometrial sampling.MethodsThis study reviewed the records of women undergoing endometrial sampling at Khon Kaen University’s Srinagarind Hospital between June 2014 and June 2015. It excluded cases in which the device could not be inserted into the uterine cavity due to pain intolerance or equipment failure. The criterion for diagnosing insufficient endometrial tissue was a lack of any intact tissue fragments containing both glands and stroma.ResultsMedical records of 233 women were reviewed. Insufficient tissue following endometrial sampling was noted in 67 cases (28.8%; 95% confidence interval [CI]=23.0–35.0). Histologic results in the remaining 166 women included normal pathological endometrium (121, 51.9%), endometrial polyps (7, 3.0%) endometrial hyperplasia (27, 11.6%), and endometrial cancer (11, 4.7%). According to multivariable analysis, menopausal status (odds ratio [OR] =3.60, 95% CI=1.84–7.05) and endometrial thickness of less than 8 mm (OR=3.91, 95% CI=1.49–10.21) were significant independent predictors for insufficient endometrial tissue after endometrial sampling.ConclusionThe incidence of insufficient tissue following endometrial sampling was 28.8%. Significant independent factors associated with an increased risk of insufficient tissue were menopausal status and endometrial thickness of less than 8 mm.

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Section: Introductionmentioning

confidence: 99%

Incidence and risk factors for insufficient endometrial tissue from endometrial sampling

Aue-aungkul¹,

Kleebkaow²,

Kietpeerakool³

2018

IJWH

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“…However, MVA is not yet widely used due to limitation of supporting data. 16,17 Previous studies found similar tissue adequacy and similar histopathologic finding between MVA and uterine curettage. [18][19][20][21] Moreover, MVA was reported to have 86.4-96% sensitivity and 100% specificity for diagnosing endometrial pathology.…”

Section: Introductionmentioning

confidence: 72%

“…In our study, tissue adequacy identified by pathologist was 95.4% from endometrial cell sampler and 86.8% from MVA, which was statistically significantly different between methods. Previous studies reported 85-98% tissue adequacy from endometrial sampling devices [5][6][7]10,14,17,23 and 81-99% from MVA. [17][18][19]23,26 This difference in tissue adequacy between methods among studies could result from different factors, such as study design, the types of devices used, the characteristics of study participants, and differences in the level of operator experience.…”

Section: Discussionmentioning

confidence: 96%

“…Despite the fact that MVA and endometrial sampling devices are both noninvasive office-based techniques, few studies have compared diagnostic performance between the two methods. Two previous studies reported that the two techniques showed comparable tissue adequacy and diagnostic accuracy 17,23 ; however, those studies did not compare the two procedures in the same woman. Moreover, the mechanism of MVA instrument may create a higher degree of negative suction pressure than endometrial sampling devices which could improve the limitation of these devices in sampling focal endometrial lesion.…”

Section: Introductionmentioning

confidence: 97%

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Correlation between Manual Vacuum Aspiration and Endometrial Cell Sampler in Abnormal Uterine Bleeding

Sirimai,

Lertbunnaphong,

Suwanthananon

et al. 2023

Siriraj Med J

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Objective: Office endometrial biopsy using an endometrial cell sampler is an accepted method of obtaining endometrial tissue for histopathologic evaluation in women with abnormal uterine bleeding (AUB). Manual vacuum aspiration (MVA) is considered an alternative method, but data specific to the use of MVA is limited. This study aimed to evaluate the efficacy of MVA compared to endometrial cell sampler for diagnosing causes of AUB. Materials and Methods: This prospective study enrolled women aged ≥35 years who presented with AUB during August 2015 to June 2016. For each patient, endometrial biopsy using an endometrial cell sampler was first performed followed by MVA. Correlation of endometrial histopathology between methods were analyzed using Kappa statistic. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were evaluated. Results: Of the 162 patients enrolled, the data from 151 women were analyzed. Correspondence of histopathologic finding between tissue obtained from endometrial cell sampler and MVA was 72.8% (Kappa: 0.51). Correspondence of histopathologic finding between tissue obtained from MVA and the final most severe pathology used for treatment decision was 84.1% (Kappa: 0.72). MVA diagnosed all cases of malignancy, but endometrial cell sampler missed one case of malignancy. The overall sensitivity, specificity, PPV, and NPV of MVA was 84.5%, 100%, 100%, and 91.2%, respectively. Conclusion: The histopathologic findings of MVA were in good agreement with those of endometrial cell sampler, and MVA had high accuracy for diagnosing endometrial pathology. MVA is suggested as a reliable alternative procedure for endometrial biopsy in women with AUB.

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“…A study in Thailand for comparison of MVA versus Pipelle device shows better tissue adequacy in pipelle group (85.6% versus 81.1%). The study also highlighted higher difficult procedure with MVA (27.0% versus 14.4%) and significantly higher moderate to severe pain with MVA (60.7% versus 19.5%) (6). In the current study all the samples including the 24 repeat samples were taken using MVA which might have exaggerated inadequate sample.…”

Section: Discussionmentioning

confidence: 88%

Review of histopathologic findings of endometrial biopsy done at a tertiary referral hospital in urban Ethiopia

Tolu

Kebtamu

Abedella

et al. 2020

Preprint

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23 Background: An endometrial sampling procedure is a gold standard for the diagnostic 24 evaluation of women with abnormal uterine bleeding (AUB) with primary aim to identify 25 the cause, especially to determine whether carcinoma or premalignant lesions are 26 present. The objective of the study is therefore to review endometrial biopsy specimen 27 histopathological findings and associated factors at a tertiary referral hospital in urban 28 Ethiopia.29 Methodology: This is a two years retrospective analysis of cases of patients for whom 30 endometrial biopsy was taken at a territory referral hospital in urban Ethiopia. Odd's ratios, 31 95% confidence interval and p-value set at 0.05 were used to determine the statistical 32 significance of the associations.33 Results: A total of 277 patient records were analyzed and mean and the median age of 34 the study patients were 41.89 and 40.00 years respectively. The commonest 35 histopathologic finding was endometrial polyp 66 (23.83%), followed by proliferative 36 endometrium 47 (16.97%) and secretory endometrium 25(9.03%). Endometrial 37 hyperplasia, endometrial malignancy, and pregnancy complications were reported in 938 (3.25%), 13 (4.69%), and 25 (9.03%) of cases respectively. Endometritis was detected in 39 20(7.22%), while Tuberculous (TB) endometritis was reported in 3(1.08%) of cases only. 40 Inconclusive and inadequate sample was reported in 30 (10.83%) and 34 (12.27%) of 41 cases respectively. Endometrial polyp was associated with 40-49 years of age (OR= 42 12.56, 95% CI: 2.58-61.23). 43 Conclusions: Endometrial polyp was the commonest histopathologic finding followed by 44 proliferative and secretory endometrium respectively. Rate of sample inadequacy is 3 | P a g e 45 higher than most of the study reports which mandates to improve sampling technique to 46 increase sample adequacy and routine transvaginal ultrasound for endometrial evaluation 47 especially for those postmenopausal women to decide the necessity of endometrial 48 sampling. 49 Key Words: Endometrial biopsy, Histopathological findings, Ethiopia 50 Background. 51 An endometrial biopsy is the removal of a small piece of tissue from the endometrium, 52 which is the lining of the uterus (1-3). This tissue sample can show cell changes due to 53 abnormal tissues or variations in hormone levels. The preferred method is an outpatient 54 office-based endometrial biopsy, usually without anesthesia or cervical dilation. For the 55 office procedure, a 2-4 mm diameter plastic cannula, with a plunger within, is used and 56 is reliable and is well accepted by the patient (1-7). 57 Sharp curettage (D& C) alone or in combination with hysteroscope might also be required 58 in case simple office sampling techniques failed to provide sufficient diagnostic 59 information or if abnormal bleeding persists after normal histopathologic findings (2, 3). 60 An endometrial sampling procedure is a gold standard for the diagnostic evaluation of 61 women with abnormal uterine bleeding (AUB) with primary aim to identify the c...

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Comparison of tissue adequacy for histologic examination from Ipas MVA plus and Wallach Endocell in women with abnormal uterine bleeding

Abstract: MVA was comparable to Endocell in terms of tissue adequacy. Moderate to severe pain was experienced significantly more in the MVA group; however, the requirement of pain treatment was not significantly different between the groups.

Cited by 5 publications

References 27 publications

Incidence and risk factors for insufficient endometrial tissue from endometrial sampling

Incidence and risk factors for insufficient endometrial tissue from endometrial sampling

Correlation between Manual Vacuum Aspiration and Endometrial Cell Sampler in Abnormal Uterine Bleeding

Review of histopathologic findings of endometrial biopsy done at a tertiary referral hospital in urban Ethiopia

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