Patient and provider factors associated with endometrial Pipelle sampling failure

Adambekov, Shalkar; Goughnour, Sharon L.; Mansuria, Suketu; Donnellan, Nicole; Elishaev, Esther; Villanueva, Hugo; Edwards, Robert P.; Bovbjerg, Dana H.; Linkov, Faina

doi:10.1016/j.ygyno.2016.11.041

Cited by 26 publications

(30 citation statements)

References 23 publications

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“…Blind endometrial biopsies have reported failure rates of as low as 8% for procedural failures and 13% for inadequate sampling . The overall failure rate including both failed procedures and insufficient tissue samples falls around 22.8% . In our cohort, excluding patients who underwent a failed blind biopsy, the failure rate for all clinically determined referrals for transabdominal US‐guided biopsy was only 15%.…”

Section: Discussionmentioning

confidence: 70%

“…9 The overall failure rate including both failed procedures and insufficient tissue samples falls around 22.8%. 6 In our cohort, excluding patients who underwent a failed blind biopsy, the failure rate for all clinically determined referrals for transabdominal US-guided biopsy was only 15%. Although transabdominal US can be challenging in patients with a high body mass index, we did not have any failed transabdominal US-guided endometrial biopsies related to the body mass index.…”

Section: Discussionmentioning

confidence: 81%

“…Office endometrial sampling is a blind procedure and can fail because of an inability to access the endometrium or may result in insufficient tissue for histopathologic analysis. Reported failure rates for Pipelle sampling are as high as 23% . Risk factors for failure include age older than 55 years, a history of biopsy failure, clinical indication of postmenopausal bleeding, and performance of the biopsy by a nonphysician .…”

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confidence: 99%

“…Reported failure rates for Pipelle sampling are as high as 23% . Risk factors for failure include age older than 55 years, a history of biopsy failure, clinical indication of postmenopausal bleeding, and performance of the biopsy by a nonphysician . Different ultrasound (US) options have been used to improve the endometrial sampling yield, such as saline infusion US guidance and abnormal bleeding algorithms including US evaluations …”

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confidence: 99%

“…6 Risk factors for failure include age older than 55 years, a history of biopsy failure, clinical indication of postmenopausal bleeding, and performance of the biopsy by a nonphysician. 6 Different ultrasound (US) options have been used to improve the endometrial sampling yield, such as saline infusion US guidance and abnormal bleeding algorithms including US evaluations. 7,8 At our institution, we introduced a program for performing endometrial sampling under transabdominal US guidance as a step before the option of surgical sampling.…”

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confidence: 99%

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Sonographically Guided Office Endometrial Sampling: Indications and Results

Dua

Egan

Balica

2018

J of Ultrasound Medicine

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Objectives The purpose of this study was to identify clinical indications in which endometrial sampling was performed under transabdominal ultrasound (US) guidance and to evaluate the outcomes of this approach in an academic practice. Methods We retrieved data from the electronic medical record for all patients referred to the gynecologic US unit for transabdominal US‐guided endometrial sampling from January 2011 to June 2017. Data retrieved included age, parity, previous cesarean delivery or pelvic surgery, indication for endometrial biopsy, US abnormalities, clinical reasoning for US‐guided sampling, and pathologic reports. Results A total of 113 patients were referred for US‐guided sampling between January 2011 and June 2017. We identified the following reasons for US‐guided biopsy referral: failed blind biopsy attempt, fibroids, uterine position or anomaly, need for targeted sampling, cervical stenosis, and other indications. Ninety‐five of the 113 patients (84%) underwent successful US‐guided endometrial sampling. Forty of the 113 patients were referred after a failed blind biopsy, with 83% subsequently undergoing successful US‐guided endometrial sampling. Of the 30 patients referred for fibroids, 29 (97%) underwent successful US‐guided sampling. High success rates were also noted for transabdominal US guidance referrals for the uterine position or anomaly (86%) and the need for targeted sampling (83%). Conclusions Our results suggest that endometrial sampling performed under US guidance could be considered for patients with a failed blind approach, fibroids, uterine anomalies, and interest in targeted sampling. In such cases, US‐guided sampling could be considered before surgical options.

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Section: Discussionmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 81%

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confidence: 99%

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confidence: 99%

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confidence: 99%

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