Ultrasound examination before, during, and after office endometrial sampling

Abstract

Office endometrial sampling is widely used as the first diagnostic test in women with abnormal uterine bleeding. Because office sampling is a blind procedure, the lesion causing the symptoms may be missed. The use of ultrasound before, during, and after office endometrial sampling improves relevant tissue yield. The measurement of the endometrial thickness informs if sampling is indicated. The evaluation of ultrasound features (without or with fluid instillation) may suggest a focal intracavitary lesion necessitating operative hysteroscopy. The knowledge of the uterine cavity length, shape, and flexion may avoid nonrepresentative sampling. The concordance between the tissue yield and the ultrasound findings reflects the reliability of the sampling. If not concordant, further diagnostic steps such as fluid instillation sonography or hysteroscopy are indicated. We conclude that integrating ultrasound in the diagnostic algorithm for uterine intracavitary pathology optimizes office endometrial sampling.

Sonographically Guided Office Endometrial Sampling: Indications and Results

“…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. This study presents the referring provider's clinical reasons for transabdominal USguided endometrial biopsy and outcomes of the procedure in this cohort of patients.…”