A prospective evaluation of an endometrial suction curette

The object of this study was to assess the reliability of a technique using an endometrial suction curette to obtain tissue for diagnosis. A prospective study was performed. One hundred sequential outpatient biopsies using the Z-Sampler were studied. All samples were reviewed a second time by a single pathologist for adequacy. In 75% of samples, a histologic diagnosis could be determined. The remaining 25% were inadequate for diagnosis--4 identified at the time of sampling and completed with a Novak curette and 21 in which the sample would not support the histologic diagnosis. Analysis of the inadequate samples found that 12 of the 25 (48%) inadequate samples came from patients with the clinical diagnosis of postmenopausal or climacteric bleeding. This diagnosis was represented in only 18 of the 75 successful biopsies (24%, p less than 0.001). The findings suggest that endometrial sampling using disposable endometrial curettes provides adequate tissue for histologic interpretation in most patients. Although patients with postmenopausal or climacteric bleeding made up one half of all patients with an inadequate sample, 60% of these patients did have interpretable tissue obtained. In these patients, use of other or adjunctive sampling methods should be entertained based on clinical or other considerations.