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Comparison of Endorette and dilatation and curettage for sampling of the endometrium in women with postmenopausal bleeding

Epstein, Elisabeth LU ; Skoog, Lennart and Valentin, Lil LU orcid (2001) In Acta Obstetricia et Gynecologica Scandinavica 80(10). p.959-964
Abstract
MAIN QUESTION: To compare the diagnostic properties of Endorette and D&C in women with postmenopausal bleeding, to relate the properties to endometrial thickness as measured by ultrasound, and to assess the women's experiences of the two methods. METHODS: In a prospective study, 133 consecutive women with postmenopausal bleeding were examined with transvaginal ultrasound. After measuring the endometrial thickness, Endorette sampling was performed without anesthesia. Dilatation and curettage (D&C) was carried out under general anesthesia within six weeks. After completion of each sampling procedure the women filled in a questionnaire regarding their experience of the sampling. RESULTS: Endorette sampling failed in 16% (21/133) of... (More)
MAIN QUESTION: To compare the diagnostic properties of Endorette and D&C in women with postmenopausal bleeding, to relate the properties to endometrial thickness as measured by ultrasound, and to assess the women's experiences of the two methods. METHODS: In a prospective study, 133 consecutive women with postmenopausal bleeding were examined with transvaginal ultrasound. After measuring the endometrial thickness, Endorette sampling was performed without anesthesia. Dilatation and curettage (D&C) was carried out under general anesthesia within six weeks. After completion of each sampling procedure the women filled in a questionnaire regarding their experience of the sampling. RESULTS: Endorette sampling failed in 16% (21/133) of the women. More than half (56%) of the women experienced moderate or strong pain during Endorette sampling, and the doctor underestimated the pain in 62% of the women. Endorette failed to diagnose two of seven (29%) endometrial cancers found at D&C. In one of these two cases, the examiner suspected that the Endorette device had not reached the uterine fundus. In women with endometrium < 7 mm, Endorette and D&C showed similar results with regard to obtaining a sufficient endometrial sample and to distinguishing normal endometrium, benign pathological endometrium and malignancy. In women with endometrium > or =7 mm, Endorette yielded insufficient samples significantly more often than D&C (23% vs 6%, p=0.02; the McNemar test) and missed all polyps and most (77%) hyperplasias diagnosed by D&C. CONCLUSION: Endorette and D&C have similar diagnostic properties in women with postmenopausal bleeding and endometrium < 7 mm. D&C is superior to Endorette in women with endometrium > or =7 mm. (Less)
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author
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
curettage, endometrial sampling, postmenopausal bleeding, ultrasound, uterine malignancy
in
Acta Obstetricia et Gynecologica Scandinavica
volume
80
issue
10
pages
959 - 964
publisher
Wiley-Blackwell
external identifiers
  • pmid:11580743
  • scopus:0034740621
ISSN
1600-0412
DOI
10.1034/j.1600-0412.2001.801015.x
language
English
LU publication?
yes
id
b363b5e5-4a61-4871-8352-ec96844796de (old id 1120568)
date added to LUP
2016-04-01 15:36:11
date last changed
2025-04-04 14:49:12
@article{b363b5e5-4a61-4871-8352-ec96844796de,
  abstract     = {{MAIN QUESTION: To compare the diagnostic properties of Endorette and D&amp;C in women with postmenopausal bleeding, to relate the properties to endometrial thickness as measured by ultrasound, and to assess the women's experiences of the two methods. METHODS: In a prospective study, 133 consecutive women with postmenopausal bleeding were examined with transvaginal ultrasound. After measuring the endometrial thickness, Endorette sampling was performed without anesthesia. Dilatation and curettage (D&amp;C) was carried out under general anesthesia within six weeks. After completion of each sampling procedure the women filled in a questionnaire regarding their experience of the sampling. RESULTS: Endorette sampling failed in 16% (21/133) of the women. More than half (56%) of the women experienced moderate or strong pain during Endorette sampling, and the doctor underestimated the pain in 62% of the women. Endorette failed to diagnose two of seven (29%) endometrial cancers found at D&amp;C. In one of these two cases, the examiner suspected that the Endorette device had not reached the uterine fundus. In women with endometrium &lt; 7 mm, Endorette and D&amp;C showed similar results with regard to obtaining a sufficient endometrial sample and to distinguishing normal endometrium, benign pathological endometrium and malignancy. In women with endometrium &gt; or =7 mm, Endorette yielded insufficient samples significantly more often than D&amp;C (23% vs 6%, p=0.02; the McNemar test) and missed all polyps and most (77%) hyperplasias diagnosed by D&amp;C. CONCLUSION: Endorette and D&amp;C have similar diagnostic properties in women with postmenopausal bleeding and endometrium &lt; 7 mm. D&amp;C is superior to Endorette in women with endometrium &gt; or =7 mm.}},
  author       = {{Epstein, Elisabeth and Skoog, Lennart and Valentin, Lil}},
  issn         = {{1600-0412}},
  keywords     = {{curettage; endometrial sampling; postmenopausal bleeding; ultrasound; uterine
malignancy}},
  language     = {{eng}},
  number       = {{10}},
  pages        = {{959--964}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Acta Obstetricia et Gynecologica Scandinavica}},
  title        = {{Comparison of Endorette and dilatation and curettage for sampling of the endometrium in women with postmenopausal bleeding}},
  url          = {{http://dx.doi.org/10.1034/j.1600-0412.2001.801015.x}},
  doi          = {{10.1034/j.1600-0412.2001.801015.x}},
  volume       = {{80}},
  year         = {{2001}},
}