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Endopap-versus Pipelle-sampling in the diagnosis of postmenopausal endometrial disease
T Van den Bosch1, A Vandendael, P A Wranz
1Department of Obstetrics and Gynecology, University of Stellenbosch, Tygerberg Hospital, South Africa.
Objective:
To evaluate the accuracy of Endopap- and Pipelle-sampling in the diagnosis of postmenopausal disease.
Study Design:
Observational study in the setting of a University Hospital. One hundred and six consecutive postmenopausal women presenting with uterine bleeding or endometrial cells on cervical cytology underwent an Endopap sampling as well as a Pipelle biopsy. Thereafter, 89 of those women underwent a hysteroscopy and curettage (n = 71) or a hysterectomy (n = 18). The diagnostic accuracy of Pipelle and Endopap was assessed against the final diagnosis.
Results:
Endometrial carcinoma was found in five cases (6%), benign disease in 34 (38%). The sensitivity of Endopap and Pipelle for the detection of endometrial disease was 56 and 51%, respectively, with a specificity of 94 and 100%, respectively. The sensitivity for endometrial carcinoma was 80% for Endopap and 100% for Pipelle.
Conclusions:
Our data tend to favor Pipelle against Endopap as diagnostic tool in endometrial disease in symptomatic postmenopausal women.