Efficacy of pipelle endometrial sampling in diagnosing endometrial pathologies in postmenopausal women with asymptomatic thick endometrium in comparison to fractional curettage

Abstract

Objective: To evaluate the efficacy of pipelle endometrial sampling (PES) in diagnosing endometrial pathologies in patients with asymptomatic thick endometrium compared to fractional curettage (FC). Methods: A prospective, comparative, observational study was conducted, involving 100 postmenopausal women with asymptomatic thickened endometrium. Demographic characteristics, clinical features, and transvaginal ultrasound measurements were recorded. PES was performed as an outpatient procedure, followed by confirmatory FC under general anesthesia. Histopathological examination was conducted for both PES and FC samples. Diagnostic accuracy, pain scores, and association with endometrial hyperplasia and carcinoma were assessed. Results: The mean age of the participants was 56.7±2.8 years, with a mean body mass index of 29.6±3.6 kg/m2. The mean endometrial thickness was 14.3±2.9 mm. PES yielded 73 (73%) adequate samples, while FC yielded 87 (87%) adequate samples. Pain scores were significantly lower for PES compared to FC (3.23±1.23 vs. 6.48±1.54, respectively, p < 0.001). PES demonstrated a sensitivity rate of 81.25% and a specificity rate of 100% for endometrial hyperplasia, and a sensitivity rate of 60% and specificity rate of 100% for endometrial carcinoma. Conclusions: Pipelle endometrial sampling is an effective and well-tolerated method for diagnosing endometrial pathologies in postmenopausal women with asymptomatic thickened endometrium.