Histopathology, Screening Tool, Techniques
Conditions
Keywords
Pipelle, Endometrial biopsy, histopathology, endometrial sampling, screening, outpatient
Brief summary
Pipelle is the most commonly used outpatient endometrial biopsy device. Pipelle endometrial biopsy can diagnose 90% of endometrial cancer cases. Pipelle endometrial biopsy is one of the first-line diagnostic procedures for women presenting with abnormal peri- and post-menopausal vaginal bleeding. Insufficient samples are obtained in 5-23% of cases. In Adan Hospital, a retrospective analysis of all outpatient endometrial samples sent to the histopathology department from April- to October 2024 study showed an insufficient sample percentage of 32% This may be attributed to factors such as patients, equipment, and physicians. This project aims to improve the endometrial biopsy results by Identifying these factors in the Adan hospital setting, Implementing measures to modify these factors, and finally re-auditing the endometrial biopsy results after six months.
Interventions
OTHERImproving technique
A checklist was developed to ensure the important steps were followed, with tips for obtaining a more adequate sample. This checklist was put in the outpatient procedures room, and each physician performing a biopsy was asked to fill it out. Also, a diagram containing illustrative images with the basic steps was put in the procedures room. The topic was covered in the biweekly scientific meeting, and all factors attributed to the inadequate sample were discussed. The department lead mentioned the topic in the OBGYN department's private messaging group. It was finally mentioned in the morning meeting.
OTHERUsing hysteroscopy in candidate patients
Patients with focal lesions on ultrasound will undergo hysteroscopy and biopsy instead of blind endometrial sampling. Patient with stenosed cervix or failed previous sampling might also undergo hysteroscopic guided biopsy.
OTHERAnalgesia
Analgesia in the form of paracetamol or NSAIDs might be given to some patients 30- 60 minutes before the procedure to reduce the procedure-associated pain and the resultant failure to complete it and obtain an adequate sample.
Sponsors
Al Adan Hospital Kuwait
Cairo University
Study design
Observational model
OTHER
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Healthy volunteers
No
Inclusion criteria
* All patients undergoing outpatient endometrial biopsy in the specified time interval (11/2024- 4/2025) will be included.
Exclusion criteria
* Could not obtain the sample due to patient physicals, anxiety (patient decline), cervical stenosis, or severe bleeding
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Adequacy of the sampled endometrial specimen for histopathology diagnosis | six months |
Countries
Kuwait
Outcome results
None listed