Endometrial sampling using the Mi Mark procedure as a primary routine: first year's experience

This study reports on the Mi Mark technique as a primary method of endometrial sampling in routine practice. The experience gained during the first year was evaluated with regard to diagnostic accuracy and acceptability. In total, 736 patients were examined using either the Mi Mark technique or dilatation and curettage (D&C). In the pre-menopausal and post-menopausal women, in the study group, 11% and 30%, respectively, of the Mi Mark specimens proved too scanty for evaluation. In women aged over 60 the proportion of specimens that were inadequate for diagnosis was around 60% and the Mi Mark technique was not therefore considered to be suitable for use in this age group. If the latter group is excluded, the Mi Mark procedure could replace D&C in 47% of cases. Where the sampling material obtained was inadequate a secondary D&C was performed, following which an atrophic endometrium was usually found, although endometrial cancers were detected in 2 cases. Thus, an inadequate specimen obtained by means of the Mi Mark helix did not exclude the possibility of endometrial malignancy. When questioned, 8% of the patients stated that they considered the pain associated with the examination to be severe. On the other hand, 93% were prepared to undergo another Mi Mark procedure if necessary. The Mi Mark technique was considered to be adequate in terms of both acceptability and accuracy provided a D&C was performed in cases where the Mi Mark specimen was inadequate for evaluation.