Endocervical sampling by Kevorkian curette or Pipelle aspiration device: a randomized comparison.

Abstract

Our purpose was to compare two means of endocervical sampling-the Kevorkian curette and the Pipelle aspiration device (Unimar Co., Wilton, Conn.)-with respect to patient discomfort, tissue volume, and specimen adequacy for diagnosis. Fifty-two women undergoing investigation of abnormal cervical cytologic results were assigned randomly to endocervical sampling by Kevorkian or Pipelle instruments. Pain associated with the procedure was assessed by having each subject indicate her pain level on a visual analog scale. Tissue volume was graded by examination of the microscopic slides by two investigators blinded to assignment. Adequacy for diagnosis was evaluated by reviewing pathology reports. Subjects having Pipelle endocervical aspiration (n = 24) had significantly lower mean (+/- SEM) pain scores (27 +/- 5 vs 48.5 +/- 7, p = 0.02) than those in whom the Kevorkian instrument was used (n = 28). However, there were no significant differences in tissue volume obtained or in proportions considered adequate for diagnosis. Use of the Pipelle instrument was associated with less patient discomfort than Kevorkian curettage for endocervical sampling while providing similar tissue volume and adequacy for diagnosis.