A randomised trial of Medgyn Endosampler® vs Endocurette® in an outpatient hysteroscopy clinic setting

A. S. Khalid, C. Burke
2014 Gynecological Surgery  
Outpatient hysteroscopy and endometrial biopsy are increasingly being used in the investigation of abnormal uterine bleeding. In our unit, both Endocurette® and Endosampler® endometrial biopsy devices are available in the outpatient hysteroscopy clinic. Literature comparing these devices is lacking. This was a prospective, randomised trial involving women attending the outpatient hysteroscopy clinic at Cork University Maternity Hospital. Women were randomised to endometrial sampling with either
more » ... Endosampler® or Endocurette® devices. A number of device insertions, pain scores, ease of handling and histological reporting of sample adequacy and tissue histology were recorded. One hundred and six women were recruited comprising 55 pre-menopausal and 51 post-menopausal women. A substantially higher rate of multiple device insertions to obtain a visually adequate sample was recorded using Endocurette® compared with Endosampler®. In the Endosampler® group, 10.7 and 12.5 % of women in pre-and post-menopausal categories had ≥2 device insertions compared to 88.8 and 58.3 %, respectively, with Endocurette® (p=0.002 and p=0.0001). There was no difference in the rate of histologically inadequate samples or difficulty with device handling between matched groups. Mean pain scores in the pre-and post-menopausal groups were 5.83 and 4.58 for Endosampler®, and 4.69 and 4.88 for Endocurette® (p=0.02). The rate of histologically inadequate samples was higher in postmenopausal compared to pre-menopausal women (27.4 vs 3.7 %, p=0.0025). A significantly lower rate of multiple device insertions for adequate histological sample was recorded with Endosampler®. No significant differences in operational difficulties, patient acceptability and sample adequacy were shown. Higher overall pain scores were reported with Endosampler® with no difference in the rate of severe pain between groups' satisfaction with the procedure or willingness to undergo the procedure again.
doi:10.1007/s10397-014-0848-2 fatcat:mxekbaqgbzei5k4qfq6llkv7xa